Provider Demographics
NPI:1104829704
Name:SCHUYLER COUNTY HEALTH CENTER
Entity Type:Organization
Organization Name:SCHUYLER COUNTY HEALTH CENTER
Other - Org Name:SCHUYLER COUNTY HEALTH DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGERS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:660-457-3721
Mailing Address - Street 1:PO BOX 387
Mailing Address - Street 2:213 S. GREEN ST.
Mailing Address - City:LANCASTER
Mailing Address - State:MO
Mailing Address - Zip Code:63548-1907
Mailing Address - Country:US
Mailing Address - Phone:660-457-3721
Mailing Address - Fax:660-457-2238
Practice Address - Street 1:213 S. GREEN ST.
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:MO
Practice Address - Zip Code:63548-1907
Practice Address - Country:US
Practice Address - Phone:660-457-3721
Practice Address - Fax:660-457-2238
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-27
Last Update Date:2017-03-27
Deactivation Date:2007-07-17
Deactivation Code:
Reactivation Date:2008-02-06
Provider Licenses
StateLicense IDTaxonomies
MO00010439251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO261952006Medicaid
MO281952002Medicaid
MO511933707Medicaid
MO581952009Medicaid
MO581952009Medicaid