Provider Demographics
NPI:1871767962
Name:COUNTY OF DONIPHAN
Entity type:Organization
Organization Name:COUNTY OF DONIPHAN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHERYL
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:PIERCE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:785-985-3591
Mailing Address - Street 1:PO BOX 609
Mailing Address - Street 2:201 S. MAIN ST
Mailing Address - City:TROY
Mailing Address - State:KS
Mailing Address - Zip Code:66087-0609
Mailing Address - Country:US
Mailing Address - Phone:785-985-3591
Mailing Address - Fax:
Practice Address - Street 1:201 S MAIN ST
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:KS
Practice Address - Zip Code:66087-4001
Practice Address - Country:US
Practice Address - Phone:785-985-3591
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-18
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSA-022-001251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100068770AMedicaid
KS100094720AMedicaid
KS100094720BMedicaid
KS0259OtherBC-BS HOME HEALTH
KS10001450000OtherCOMMUNITY HEALTH PLAN
KS12781OtherBC-BS HEALTH DEPT
KS100094720AMedicaid