Healthcare Provider Details

I. General information

NPI: 1760445829
Provider Name (Legal Business Name): COUNTY OF WICHITA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 01/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 S. INDIAN RD.
LEOTI KS
67861
US

IV. Provider business mailing address

104 S. INDIAN RD.
LEOTI KS
67861
US

V. Phone/Fax

Practice location:
  • Phone: 620-375-2289
  • Fax: 620-375-2826
Mailing address:
  • Phone: 620-375-2289
  • Fax: 620-375-2826

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License NumberKS 04-28583
License Number StateKS

VIII. Authorized Official

Name: MS. LEANNA F. BINNS
Title or Position: BUSINESS ADMINISTRATOR
Credential:
Phone: 620-375-2289