Provider Demographics
NPI:1154787190
Name:LABETTE COUNTY MEDICAL CENTER
Entity type:Organization
Organization Name:LABETTE COUNTY MEDICAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO/COO
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:L
Authorized Official - Last Name:MACARONAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-820-5251
Mailing Address - Street 1:PO BOX 736
Mailing Address - Street 2:
Mailing Address - City:PARSONS
Mailing Address - State:KS
Mailing Address - Zip Code:67357
Mailing Address - Country:US
Mailing Address - Phone:620-577-4310
Mailing Address - Fax:620-577-4312
Practice Address - Street 1:510 PETER PAN RD STE B
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:KS
Practice Address - Zip Code:67301-7300
Practice Address - Country:US
Practice Address - Phone:620-577-4310
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LABETTE COUNTY MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-01-06
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health