Provider Demographics
NPI:1003950189
Name:CLOUD COUNTY HEALTH CENTER INC
Entity Type:Organization
Organization Name:CLOUD COUNTY HEALTH CENTER INC
Other - Org Name:FAMILY CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:GARNAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-243-1234
Mailing Address - Street 1:155 W COLLEGE DR
Mailing Address - Street 2:
Mailing Address - City:CONCORDIA
Mailing Address - State:KS
Mailing Address - Zip Code:66901-5207
Mailing Address - Country:US
Mailing Address - Phone:785-243-4272
Mailing Address - Fax:785-243-4275
Practice Address - Street 1:155 WEST COLLEGE DRIVE
Practice Address - Street 2:
Practice Address - City:CONCORDIA
Practice Address - State:KS
Practice Address - Zip Code:66901
Practice Address - Country:US
Practice Address - Phone:785-243-4272
Practice Address - Fax:785-243-4275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS30003913460001Medicaid
KS30003913460001Medicaid