MEDICARE: COUNTY OF OTTAWA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251K00000X	Public Health or Welfare Agency	NO NUMBER	KS

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	600001517	OTHER	KS	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	119951	OTHER	KS	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1497763965
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COUNTY OF OTTAWA

Provider Business Mailing Address
First Line	:	817A ARGYLE AVE
Second Line	:
City	:	MINNEAPOLIS
State	:	KS
Zip	:	67467-1621
Country	:	US
Telephone Number	:	785-392-2822
Fax Number	:	785-392-3640

Provider Business Practice Location Address
First Line	:	817A ARGYLE AVE
Second Line	:
City	:	MINNEAPOLIS
State	:	KS
Zip	:	67467-1621
Country	:	US
Telephone Number	:	785-392-2822
Fax Number	:	785-392-3640

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MS. SANDRA K CLINE
Credential	:	RN BS
Telephone Number	:	785-392-2822

Provider Enumeration Date	:	08/03/2006
Last Update Date	:	06/02/2009

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Directions to “COUNTY OF OTTAWA ” Practice Location

Language	Start Address	Practice Location

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