Provider Demographics
NPI:1255333241
Name:COUNTY OF ROOKS
Entity Type:Organization
Organization Name:COUNTY OF ROOKS
Other - Org Name:ROOKS COUNTY HOME HEALTH AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:EICHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:785-425-7352
Mailing Address - Street 1:426 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:KS
Mailing Address - Zip Code:67669-1930
Mailing Address - Country:US
Mailing Address - Phone:785-425-7352
Mailing Address - Fax:785-425-7343
Practice Address - Street 1:426 MAIN ST
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:KS
Practice Address - Zip Code:67669-1930
Practice Address - Country:US
Practice Address - Phone:785-425-7352
Practice Address - Fax:785-425-7343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-10
Last Update Date:2015-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSA082-001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100097910BMedicaid
KS526OtherBC/BS
KS17-7078Medicare ID - Type Unspecified