1003819251 NPI number — COUNTY OF NORTON

Table of content: (NPI 1003819251)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003819251 NPI number — COUNTY OF NORTON

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNTY OF NORTON
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
NORTON COUNTY HEALTH DEPARTMENT
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003819251
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/12/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
801 N NORTON AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTON
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
67654-1432
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
785-877-5745
Provider Business Mailing Address Fax Number:
785-877-5746

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
801 N NORTON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTON
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67654-1432
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-877-5745
Provider Business Practice Location Address Fax Number:
785-877-5746
Provider Enumeration Date:
05/23/2005

Additional Information

Authorized Official

Authorized Official Last Name:
FRACK
Authorized Official First Name:
GINA
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
785-877-5745

Provider Taxonomy Codes

  • Taxonomy code: 251K00000X , with the licence number:  11-00135 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 100089220A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 012792 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 629670 . This is a "FIRSTGUARD" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".




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