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General NPI Number Information
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NPI Number | 1073624607
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Entity Type | Organization
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Legal Business Name | COUNTY OF REPUBLIC
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 08/05/2019
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Provider Practice Location Address
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Address Line | 2316 G ST
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City | BELLEVILLE
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State | KS
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Zip | 66935-2452
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Country | US
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Telephone | 785-527-5671
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Fax | 785-527-2892
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Provider Business Mailing Address
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Address Line | 2316 G ST
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City | BELLEVILLE
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State | KS
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Zip | 66935-2452
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Country | US
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Telephone | 785-527-5671
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Fax | 785-527-2892
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DANIELLE SWANSON
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Credential | RN
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Telephone | 785-527-5671
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | A-079-001
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | N/A
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License Number State |
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