Basic Information
| Provider Information | |||||||||
| NPI: | 1396849840 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SUMNER REGIONAL MEDICAL CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1323 N A ST | ||||||||
| Address2: | |||||||||
| City: | WELLINGTON | ||||||||
| State: | KS | ||||||||
| PostalCode: | 671524350 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6203267451 | ||||||||
| FaxNumber: | 6203262225 | ||||||||
| Practice Location | |||||||||
| Address1: | 1323 N A ST | ||||||||
| Address2: | |||||||||
| City: | WELLINGTON | ||||||||
| State: | KS | ||||||||
| PostalCode: | 671524350 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6203267451 | ||||||||
| FaxNumber: | 6203262225 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/12/2006 | ||||||||
| LastUpdateDate: | 11/06/2007 | ||||||||
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| AuthorizedOfficialLastName: | WILSON | ||||||||
| AuthorizedOfficialFirstName: | STEPHAN | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | CHIEF FINANCIAL OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 6203991294 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QE0002X | H096002 | KS | Y | Ambulatory Health Care Facilities | Clinic/Center | Emergency Care |
No ID Information.