1821087230 NPI number — COUNTY OF LOGAN

Table of content: (NPI 1821087230)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821087230 NPI number — COUNTY OF LOGAN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNTY OF LOGAN
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:
LOGAN COUNTY HOSPITAL
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:
1821087230
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/27/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
211 CHERRY AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OAKLEY
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
67748-1201
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
785-672-3211
Provider Business Mailing Address Fax Number:
785-672-8184

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
211 CHERRY AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OAKLEY
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67748-1201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-672-3211
Provider Business Practice Location Address Fax Number:
785-672-8184
Provider Enumeration Date:
10/18/2005

Additional Information

Authorized Official

Authorized Official Last Name:
MEYER
Authorized Official First Name:
JOEE
Authorized Official Middle Name:
SHANE
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
785-672-1409

Provider Taxonomy Codes

  • Taxonomy code: 282NC0060X , with the licence number:  H055001 , 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: 000194 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".




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