Provider Demographics
NPI:1053317008
Name:SUMNER REGIONAL MEDICAL CENTER
Entity type:Organization
Organization Name:SUMNER REGIONAL MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:SAM
Authorized Official - Middle Name:
Authorized Official - Last Name:GUILD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-326-7451
Mailing Address - Street 1:1323 N. A. STREET
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:KS
Mailing Address - Zip Code:67152-4350
Mailing Address - Country:US
Mailing Address - Phone:620-326-7451
Mailing Address - Fax:620-326-2225
Practice Address - Street 1:1323 N. A. STREET
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:KS
Practice Address - Zip Code:67152-4350
Practice Address - Country:US
Practice Address - Phone:620-326-7451
Practice Address - Fax:620-326-2225
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUMNER REGIONAL MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-06-23
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSH096002273R00000X
KSH-096-002282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100088990AMedicaid
KS100088990AMedicaid
KSOTH000Medicare UPIN