MEDICARE: COFFEY COUNTY HOSPITAL

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	261QR1300X	Rural Health Clinic/Center

General Provider Information

NPI Number	:	1922246354
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COFFEY COUNTY HOSPITAL

Provider Business Mailing Address
First Line	:	1004 E MADISON ST
Second Line	:	PO BOX 70
City	:	YATES CENTER
State	:	KS
Zip	:	66783-1314
Country	:	US
Telephone Number	:	620-625-2312
Fax Number	:	620-625-3560

Provider Business Practice Location Address
First Line	:	1004 E MADISON ST
Second Line	:
City	:	YATES CENTER
State	:	KS
Zip	:	66783-1314
Country	:	US
Telephone Number	:	620-625-2312
Fax Number	:	620-625-3560

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	MERRI MICHAELS
Credential	:
Telephone Number	:	620-364-2121

Provider Enumeration Date	:	01/22/2009
Last Update Date	:	01/15/2019

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Directions to “COFFEY COUNTY HOSPITAL ” Practice Location

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