1508936972 NPI number — COUNTY OF GEARY

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508936972 NPI number — COUNTY OF GEARY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNTY OF GEARY
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:
1508936972
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/14/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 282
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
JUNCTION CITY
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66441-0282
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
785-762-5788
Provider Business Mailing Address Fax Number:
785-762-1311

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1212 WEST ASH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JUNCTION CITY
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66441
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-762-5788
Provider Business Practice Location Address Fax Number:
785-762-1311
Provider Enumeration Date:
11/09/2006

Additional Information

Authorized Official

Authorized Official Last Name:
STALLCUP
Authorized Official First Name:
GAYLE
Authorized Official Middle Name:
A
Authorized Official Title or Position:
ACCOUNTANT
Authorized Official Telephone Number:
785-762-5788

Provider Taxonomy Codes

  • Taxonomy code: 251K00000X , 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: 61101 . This is a "HUMANA GOLD CHOICE" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 0003100 . This is a "COVENTRY HEALTHCARE OF KAN" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 460032 . This is a "CHILDREN'S MERCY" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 460032 . This is a "CHILDRENS MERCY" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 68069 . This is a "KANCARE - SUNFLOWER" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 87726 . This is a "KANCARE - UNITED HEALTHCARE" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 27514 . This is a "KANCARE - AMERIGROUP" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 012713 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 012713 . This is a "MEDICARE - PUBLIC HEALTH" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: P00136791 . This is a "PALMETTO GBA RR MEDICARE" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 100097750A . This is a "UNICARE" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 100097750A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".




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