Organization
WILSON COUNTY HOSPITAL
Active
Parent organization
WILSON COUNTY HOSPITAL
Other names
Independence Family Medicine
Organization subpart
Yes
Provider details
NPI number
Legal business name
WILSON COUNTY HOSPITAL
Authorized official
LORI C SMITH (CFO)
(620) 325-8388
Entity
Organization
Contact information
Practice address
1415 N PENN AVE, INDEPENDENCE, KS 67301-2222
(620) 331-2400
(620) 331-0747
Mailing address
PO BOX 360, NEODESHA, KS 66757-0360
(620) 325-2611
(620) 325-8453
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
012213
MEDICARE PART B PTAN
KS
Enumeration date
05/07/2013
Last updated
09/25/2024
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