Healthcare Provider Details

I. General information

NPI: 1063568897
Provider Name (Legal Business Name): COUNTY OF LINN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2007
Last Update Date: 08/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

902 MAIN ST P.0.BOX 456
PLEASANTON KS
66075-4078
US

IV. Provider business mailing address

PO BOX 456 902 MAIN
PLEASANTON KS
66075-0456
US

V. Phone/Fax

Practice location:
  • Phone: 913-352-6640
  • Fax: 913-352-6730
Mailing address:
  • Phone: 913-352-6640
  • Fax: 913-352-6730

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. DONNA M THOMAS
Title or Position: ADMINISTRATOR
Credential:
Phone: 913-352-6640