Provider Demographics
NPI:1225167414
Name:COUNTY OF STANTON
Entity Type:Organization
Organization Name:COUNTY OF STANTON
Other - Org Name:STANTON COUNTY HEALTH DEPT.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:620-492-6443
Mailing Address - Street 1:PO BOX 548
Mailing Address - Street 2:
Mailing Address - City:JOHNSON
Mailing Address - State:KS
Mailing Address - Zip Code:67855-0548
Mailing Address - Country:US
Mailing Address - Phone:620-492-6443
Mailing Address - Fax:620-492-1440
Practice Address - Street 1:114 NORTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:KS
Practice Address - Zip Code:67855-0548
Practice Address - Country:US
Practice Address - Phone:620-492-6443
Practice Address - Fax:620-492-1440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100097820AMedicaid