Healthcare Provider Details

I. General information

NPI: 1043040637
Provider Name (Legal Business Name): ROOKS COUNTY HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2024
Last Update Date: 08/07/2024
Certification Date: 06/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 S SPRUCE ST
STOCKTON KS
67669-1200
US

IV. Provider business mailing address

PO BOX 389
PLAINVILLE KS
67663-0389
US

V. Phone/Fax

Practice location:
  • Phone: 785-425-6921
  • Fax: 785-434-2577
Mailing address:
  • Phone: 785-434-4553
  • Fax: 785-434-2434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. JEFFREY B VAN DYKE
Title or Position: INTERIM CEO
Credential:
Phone: 785-688-3695