Healthcare Provider Details

I. General information

NPI: 1427096999
Provider Name (Legal Business Name): BARBER COUNTY HOME HEALTH AGENCY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 01/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107A N. MAIN ST.
MEDICINE LODGE KS
67104-1316
US

IV. Provider business mailing address

P.O. BOX 194
MEDICINE LODGE KS
67104-0194
US

V. Phone/Fax

Practice location:
  • Phone: 620-886-3120
  • Fax: 620-886-3129
Mailing address:
  • Phone: 620-886-3120
  • Fax: 620-886-3129

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberA004001
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateKS
# 3
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberA-004-001
License Number StateKS

VIII. Authorized Official

Name: MRS. LYNETTE DIANN MORRIS
Title or Position: OWNER/ADMINISTRATOR
Credential: RN
Phone: 620-886-3120