1497749774 NPI number — COUNTY OF MITCHELL

Table of content: (NPI 1497749774)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497749774 NPI number — COUNTY OF MITCHELL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNTY OF MITCHELL
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:
Provider Other Organization Name Type Code:
6
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:
1497749774
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/27/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
310 W 8TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BELOIT
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
67420-1603
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
785-738-5175
Provider Business Mailing Address Fax Number:
785-738-5053

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
310 W 8TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BELOIT
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67420-1603
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-738-5175
Provider Business Practice Location Address Fax Number:
785-738-5053
Provider Enumeration Date:
09/01/2005

Additional Information

Authorized Official

Authorized Official Last Name:
DOWLIN
Authorized Official First Name:
PATRICIA
Authorized Official Middle Name:
A
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
785-738-5175

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  A-062-001 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 642600 . This is a "FIRSTGUARD HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 10001500A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100092270A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00539 . This is a "BC/BS HOME HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 012755 . This is a "BLUE CROSS/BLUE SHIELD" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 100092270B , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 11477 . This is a "PREFERRED HEALTH SYSTEMS" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com