Organization
MINNEOLA DISTRICT HOSPITAL NBR 2
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH BRUNER (CEO)
(620) 885-4264
Entity
Organization
Contact information
Practice address
212 MAIN STREET, MINNEOLA, KS 67865-8511
(620) 885-4264
(620) 885-4602
Mailing address
BOX 127, MINNEOLA, KS 67865-0127
(620) 885-4264
(620) 885-4602
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
H013002
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000185
BLUE CROSS BLUE SHIELD
KS
01
—
014061
BLUE SHIELD (PC)
—
05
—
100099190A
—
KS
05
—
100099190B
—
KS
01
—
171368A000000
UNDOCUMENTED ALIENS
KS
Enumeration date
09/29/2006
Last updated
06/08/2015
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