Organization
FREDONIA REGIONAL HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY LYNN ROW (BUSINESS OFFICE MANAGER)
(620) 378-6204
Entity
Organization
Contact information
Practice address
1527 MADISON ST, FREDONIA, KS 66736-1751
(620) 378-2121
(620) 378-3169
Mailing address
1527 MADISON, FREDONIA, KS 66736-0579
(620) 378-2121
(620) 378-3169
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
—
282NC0060X
Critical Access Hospital
Primary
H103001
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100102250B
—
KS
05
—
100102550A
—
KS
05
—
100102550D
—
KS
01
—
12209
BCBS CRNA
KS
01
—
14075
BCBS ER PHY
KS
01
—
305
BCBS ACUTE IPOP
KS
01
—
5698
BCBS AMBULANCE
KS
Enumeration date
07/22/2005
Last updated
03/10/2021
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