Healthcare Provider Details

I. General information

NPI: 1356345888
Provider Name (Legal Business Name): COFFEY COUNTY MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1004 E MADISON ST
YATES CENTER KS
66783-1314
US

IV. Provider business mailing address

1004 E MADISON ST
YATES CENTER KS
66783-1314
US

V. Phone/Fax

Practice location:
  • Phone: 620-625-2312
  • Fax: 620-625-3560
Mailing address:
  • Phone: 620-625-2312
  • Fax: 620-625-3560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. PATRICIA A. ATKIN
Title or Position: OFFICE MANAGER
Credential:
Phone: 620-625-3647