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General NPI Number Information
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NPI Number | 1477506434
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Entity Type | Organization
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Legal Business Name | COUNTY OF WILSON
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 11/29/2007
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Provider Practice Location Address
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Address Line | 421 N 7TH ST
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City | FREDONIA
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State | KS
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Zip | 66736-1342
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Country | US
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Telephone | 620-378-4455
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Fax | 620-378-4647
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Provider Business Mailing Address
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Address Line | 421 N 7TH ST
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City | FREDONIA
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State | KS
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Zip | 66736-1342
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Country | US
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Telephone | 620-378-4455
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Fax | 620-378-4647
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. TODD DURHAM
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Credential | RN
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Telephone | 620-378-4455
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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