Basic Information
| Provider Information | |||||||||
| NPI: | 1346403284 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ST CATHERINE HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 115 N MAIN ST | ||||||||
| Address2: | |||||||||
| City: | GARDEN CITY | ||||||||
| State: | KS | ||||||||
| PostalCode: | 678465459 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6202759752 | ||||||||
| FaxNumber: | 6202754306 | ||||||||
| Practice Location | |||||||||
| Address1: | 115 N MAIN ST | ||||||||
| Address2: | |||||||||
| City: | GARDEN CITY | ||||||||
| State: | KS | ||||||||
| PostalCode: | 678465459 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6202759752 | ||||||||
| FaxNumber: | 6202754306 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/09/2008 | ||||||||
| LastUpdateDate: | 10/22/2008 | ||||||||
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| AuthorizedOfficialLastName: | MILLER | ||||||||
| AuthorizedOfficialFirstName: | JACQUELINE | ||||||||
| AuthorizedOfficialMiddleName: | RAE | ||||||||
| AuthorizedOfficialTitleorPosition: | CLINIC ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 6202759752 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | ST CATHERINE HOSPITAL | ||||||||
| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.