Provider Demographics
NPI:1285731406
Name:COUNTY OF COFFEY
Entity type:Organization
Organization Name:COUNTY OF COFFEY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LINDSAY
Authorized Official - Middle Name:R
Authorized Official - Last Name:PAYER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:620-364-8631
Mailing Address - Street 1:110 S 6TH ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:KS
Mailing Address - Zip Code:66839-1798
Mailing Address - Country:US
Mailing Address - Phone:620-364-8631
Mailing Address - Fax:620-364-2045
Practice Address - Street 1:110 S 6TH ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:KS
Practice Address - Zip Code:66839-1798
Practice Address - Country:US
Practice Address - Phone:620-364-8631
Practice Address - Fax:620-364-2045
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF COFFEY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-20
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS460006OtherCHILDREN'S MERCY FAMILY HEALTH PARTNERS
KS012754OtherBLUE CROSS BLUE SHIELD
KS100016510CMedicaid
KS012754Medicare PIN