Provider Demographics
NPI:1285742536
Name:GREELEY COUNTY HEALTH SERVICES, INC.
Entity type:Organization
Organization Name:GREELEY COUNTY HEALTH SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TRICE
Authorized Official - Middle Name:
Authorized Official - Last Name:WATTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-376-4221
Mailing Address - Street 1:PO BOX 338
Mailing Address - Street 2:
Mailing Address - City:TRIBUNE
Mailing Address - State:KS
Mailing Address - Zip Code:67879-0338
Mailing Address - Country:US
Mailing Address - Phone:620-376-4221
Mailing Address - Fax:620-376-2406
Practice Address - Street 1:506 THIRD ST.
Practice Address - Street 2:
Practice Address - City:TRIBUNE
Practice Address - State:KS
Practice Address - Zip Code:67879
Practice Address - Country:US
Practice Address - Phone:620-376-4221
Practice Address - Fax:620-376-2406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-28
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSH-036-001282N00000X, 282NC0060X, 367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical AccessGroup - Single Specialty
No282N00000XHospitalsGeneral Acute Care Hospital
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS110852OtherBCBS CRNA OLD
KS000106OtherBLUE CROSS PROVIDER NUMBE
KS180056OtherBCBS CRNA
KS200383210EMedicaid
KS171359Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER