Healthcare Provider Details

I. General information

NPI: 1578657342
Provider Name (Legal Business Name): COFFEY COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 01/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 N 4TH
BURLINGTON KS
66839-2602
US

IV. Provider business mailing address

801 N 4TH
BURLINGTON KS
66839-2602
US

V. Phone/Fax

Practice location:
  • Phone: 620-364-2121
  • Fax: 620-364-4525
Mailing address:
  • Phone: 620-364-2121
  • Fax: 620-364-8425

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberA016-002
License Number StateKS

VIII. Authorized Official

Name: MERRI MICHAELS
Title or Position: BILLING MANAGER
Credential:
Phone: 620-364-2121