Healthcare Provider Details

I. General information

NPI: 1255333241
Provider Name (Legal Business Name): COUNTY OF ROOKS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 09/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

426 MAIN ST
STOCKTON KS
67669-1930
US

IV. Provider business mailing address

426 MAIN ST
STOCKTON KS
67669-1930
US

V. Phone/Fax

Practice location:
  • Phone: 785-425-7352
  • Fax: 785-425-7343
Mailing address:
  • Phone: 785-425-7352
  • Fax: 785-425-7343

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberA082-001
License Number StateKS

VIII. Authorized Official

Name: MRS. LORI EICHMAN
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 785-425-7352