Provider Demographics
NPI:1427096999
Name:BARBER COUNTY HOME HEALTH AGENCY
Entity type:Organization
Organization Name:BARBER COUNTY HOME HEALTH AGENCY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LYNETTE
Authorized Official - Middle Name:DIANN
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:620-886-3120
Mailing Address - Street 1:P.O. BOX 194
Mailing Address - Street 2:
Mailing Address - City:MEDICINE LODGE
Mailing Address - State:KS
Mailing Address - Zip Code:67104-0194
Mailing Address - Country:US
Mailing Address - Phone:620-886-3120
Mailing Address - Fax:620-886-3129
Practice Address - Street 1:107A N. MAIN ST.
Practice Address - Street 2:
Practice Address - City:MEDICINE LODGE
Practice Address - State:KS
Practice Address - Zip Code:67104-1316
Practice Address - Country:US
Practice Address - Phone:620-886-3120
Practice Address - Fax:620-886-3129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSA004001251E00000X
KS251E00000X
KSA-004-001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100117580BMedicaid
177074Medicare UPIN