Basic Information
| Provider Information | |||||||||
| NPI: | 1467412825 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WILLIAM NEWTON MEMORIAL HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1300 E 5TH AVE | ||||||||
| Address2: | |||||||||
| City: | WINFIELD | ||||||||
| State: | KS | ||||||||
| PostalCode: | 671562407 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6202212300 | ||||||||
| FaxNumber: | 6202213594 | ||||||||
| Practice Location | |||||||||
| Address1: | 1305 E 5TH AVE | ||||||||
| Address2: | |||||||||
| City: | WINFIELD | ||||||||
| State: | KS | ||||||||
| PostalCode: | 671562406 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6202212300 | ||||||||
| FaxNumber: | 6202213594 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/27/2006 | ||||||||
| LastUpdateDate: | 12/21/2018 | ||||||||
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| AuthorizedOfficialLastName: | QUINTON | ||||||||
| AuthorizedOfficialFirstName: | J | ||||||||
| AuthorizedOfficialMiddleName: | BEN | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 6202212300 | ||||||||
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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 | 251E00000X | H018002 | KS | Y | Agencies | Home Health |
ID Information
| ID | Type | State | Issuer | Description | 100005090D | 05 | KS | MEDICAID | 000545 | 01 | KS | BLUE CROSS | OTHER |