1700824398 NPI number — MIAMI COUNTY MEDICAL CENTER INC

Table of content: (NPI 1700824398)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700824398 NPI number — MIAMI COUNTY MEDICAL CENTER INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MIAMI COUNTY MEDICAL CENTER INC
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:
MIAMI COUNTY MEDICAL CENTER
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:
1700824398
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/16/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2100 BAPTISTE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PAOLA
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66071-1314
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
913-294-2327
Provider Business Mailing Address Fax Number:
913-294-9897

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2100 BAPTISTE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PAOLA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66071-1314
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-294-2327
Provider Business Practice Location Address Fax Number:
913-294-9897
Provider Enumeration Date:
06/03/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GRASSER
Authorized Official First Name:
TIERNEY
Authorized Official Middle Name:
L
Authorized Official Title or Position:
SR. VP/CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
913-791-4461

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  H061001 , 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: 100099280A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".