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General NPI Number Information
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NPI Number | 1477685162
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Entity Type | Organization
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Legal Business Name | PHILLIPS COUNTY RETIREMENT CORPORATION
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Dates
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Enumeration Date | 03/09/2007
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Last Update Date | 06/26/2012
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Provider Practice Location Address
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Address Line | 1300 STATE STREET
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City | PHILLIPSBURG
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State | KS
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Zip | 67661
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Country | US
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Telephone | 785-543-2131
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Fax | 785-543-5200
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Provider Business Mailing Address
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Address Line | 1300 STATE STREET P.O. BOX 628
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City | PHILLIPSBURG
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State | KS
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Zip | 67661
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Country | US
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Telephone | 785-543-2131
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Fax | 785-543-5200
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. KRISTI KUCK
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Credential |
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Telephone | 785-543-2131
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | N074003
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License Number State | KS
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