Healthcare Provider Details

I. General information

NPI: 1104970144
Provider Name (Legal Business Name): UNIFIED SCHOOL DISTRICT 489
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

323 W 12TH ST
HAYS KS
67601-3812
US

IV. Provider business mailing address

323 W 12TH ST
HAYS KS
67601-3812
US

V. Phone/Fax

Practice location:
  • Phone: 785-623-2400
  • Fax: 785-623-2412
Mailing address:
  • Phone: 785-623-2400
  • Fax: 785-623-2412

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1000X
TaxonomyStudent Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. FRED KAUFMAN
Title or Position: SUPERINTENDENT
Credential:
Phone: 785-623-2400