Healthcare Provider Details

I. General information

NPI: 1275528762
Provider Name (Legal Business Name): PHILLIPS COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2005
Last Update Date: 08/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

784 6TH ST
PHILLIPSBURG KS
67661-1939
US

IV. Provider business mailing address

784 6TH ST
PHILLIPSBURG KS
67661-1939
US

V. Phone/Fax

Practice location:
  • Phone: 785-543-6850
  • Fax: 785-543-6852
Mailing address:
  • Phone: 785-543-6850
  • Fax: 785-543-6852

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: MISS LOUETTA JOANN FORELL
Title or Position: ADMINISTRATOR/HEALTH OFFICER
Credential: RN
Phone: 785-543-6850