Organization
SUSAN B. ALLEN MEMORIAL HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA HALL (CEO)
(316) 322-4558
Entity
Organization
Contact information
Practice address
720 W CENTRAL AVE, EL DORADO, KS 67042-2112
(316) 321-3300
(316) 321-4810
Mailing address
720 W CENTRAL AVE, EL DORADO, KS 67042-2112
(316) 321-3300
(316) 321-4810
Taxonomy
Speciality
Code
Description
License number
State
275N00000X
Medicare Defined Swing Bed Hospital Unit
Primary
H-008-002
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001596
BLUE CROSS BLUE SHIELD
KS
Enumeration date
09/07/2006
Last updated
05/16/2024
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