Healthcare Provider Details

I. General information

NPI: 1548372865
Provider Name (Legal Business Name): COUNTY OF THOMAS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 S RANGE AVE STE 2
COLBY KS
67701-2966
US

IV. Provider business mailing address

350 S RANGE AVE STE 2
COLBY KS
67701-2966
US

V. Phone/Fax

Practice location:
  • Phone: 785-460-4596
  • Fax: 785-460-4595
Mailing address:
  • Phone: 785-460-4596
  • Fax: 785-460-4595

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number StateKS

VIII. Authorized Official

Name: MRS. KASIAH S ROTHCHILD
Title or Position: FINANCE ADMINISTRATOR
Credential:
Phone: 785-460-4596