Provider Demographics
NPI:1104918762
Name:SOUTHEAST KANSAS MULTI-COUNTY HEALTH DEPT
Entity type:Organization
Organization Name:SOUTHEAST KANSAS MULTI-COUNTY HEALTH DEPT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SECRETARY, BOARD OF DIRECTORS
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:LOHMON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:620-365-2191
Mailing Address - Street 1:411 NORTH WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:IOLA
Mailing Address - State:KS
Mailing Address - Zip Code:66749-2352
Mailing Address - Country:US
Mailing Address - Phone:620-365-2191
Mailing Address - Fax:620-365-3128
Practice Address - Street 1:411 NORTH WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:IOLA
Practice Address - State:KS
Practice Address - Zip Code:66749-2352
Practice Address - Country:US
Practice Address - Phone:620-365-2191
Practice Address - Fax:620-365-3128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS30003916120001Medicaid
KS012763Medicare PIN