Provider Demographics
NPI:1124126719
Name:COUNTY OF LOGAN
Entity type:Organization
Organization Name:COUNTY OF LOGAN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/RN
Authorized Official - Prefix:MRS
Authorized Official - First Name:GEORGETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHOENFELD
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:785-671-4502
Mailing Address - Street 1:216 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLEY
Mailing Address - State:KS
Mailing Address - Zip Code:67748-1220
Mailing Address - Country:US
Mailing Address - Phone:785-671-4502
Mailing Address - Fax:785-671-4989
Practice Address - Street 1:216 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:OAKLEY
Practice Address - State:KS
Practice Address - Zip Code:67748-1220
Practice Address - Country:US
Practice Address - Phone:785-671-4502
Practice Address - Fax:785-671-4989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2013-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100091660AMedicaid
KS012777Medicare UPIN