Organization
GREAT BEND REGIONAL HOSPITAL, LLC
Active
Parent organization
GREAT BEND REGIONAL HOSPITAL, LLC
Other names
Central Kansas Medical Park Ancillary Service
Organization subpart
Yes
Provider details
NPI number
Legal business name
GREAT BEND REGIONAL HOSPITAL, LLC
Authorized official
MR. ROBERT E BAUM (ADMINISTRATOR)
(620) 792-5341
Entity
Organization
Contact information
Practice address
1309 POLK ST, GREAT BEND, KS 67530-3644
(620) 792-4266
(620) 792-2665
Mailing address
1309 POLK ST, GREAT BEND, KS 67530
(620) 792-5404
(620) 792-2665
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
106062
KS
291U00000X
Clinical Medical Laboratory
Primary
17D0452731
KS
Other
Enumeration date
01/25/2013
Last updated
03/10/2016
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