HIAWATHA HOSPITAL ASSOCIATION INC NPI 1023175064

NPI Information

NPI: 1023175064
Provider Name: HIAWATHA HOSPITAL ASSOCIATION INC

Doing Business As: AMBERWELL HIAWATHA PRIMARY CARE CLINIC

Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

CLIA Number: 17D2193879

Address:
300 UTAH ST FL 2
HIAWATHA, KS
ZIP 66434
Phone: (785) 742-2161
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HIAWATHA HOSPITAL ASSOCIATION INC is a rural health clinic center in Hiawatha, KS. HIAWATHA HOSPITAL ASSOCIATION INC NPI is 1023175064. The provider is registered as an organization entity type.
The provider Is Doing Business As Amberwell Hiawatha Primary Care Clinic.

The provider's business location address is:

300 UTAH ST FL 2
HIAWATHA, KS
ZIP 66434-314
Phone: (785) 742-2161
Fax: (785) 742-6554

The provider's authorized official is Jeff R Perry .
The authorized official title is Ceo and has the following contact phone number (785) 742-6283.

The CLIA number assigned to this NPI record is 17D2193879 - rural health clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/2/2007 and was last updated on 2/7/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR1300X	Clinic/Center	Rural Health			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	100098990B	MEDICAID	KANSAS
2	100098990E	MEDICAID	KANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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