1831243856 NPI number — COUNTY OF GREENWOOD

Table of content: (NPI 1831243856)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831243856 NPI number — COUNTY OF GREENWOOD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNTY OF GREENWOOD
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:
1831243856
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/16/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
200 W 1ST ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EUREKA
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
67045-1504
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
620-583-6632
Provider Business Mailing Address Fax Number:
620-583-7709

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 W 1ST ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EUREKA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67045-1504
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
620-583-6632
Provider Business Practice Location Address Fax Number:
620-583-7709
Provider Enumeration Date:
01/23/2007

Additional Information

Authorized Official

Authorized Official Last Name:
HANCOCK
Authorized Official First Name:
MARY
Authorized Official Middle Name:
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
620-583-6632

Provider Taxonomy Codes

  • Taxonomy code: 251K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 119964 . This is a "BCBS OF KS" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 100092140A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com