Provider Demographics
NPI:1275745085
Name:COUNTY OF NESS
Entity Type:Organization
Organization Name:COUNTY OF NESS
Other - Org Name:NESS COUNTY HEALTH DEPARTMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:EVA
Authorized Official - Middle Name:JO
Authorized Official - Last Name:PETERSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-798-3388
Mailing Address - Street 1:PO BOX 414
Mailing Address - Street 2:
Mailing Address - City:NESS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67560-0414
Mailing Address - Country:US
Mailing Address - Phone:785-798-3388
Mailing Address - Fax:785-798-2389
Practice Address - Street 1:202 W SYCAMORE ST
Practice Address - Street 2:
Practice Address - City:NESS CITY
Practice Address - State:KS
Practice Address - Zip Code:67560-1564
Practice Address - Country:US
Practice Address - Phone:785-798-3388
Practice Address - Fax:785-798-2389
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2009-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS13-91625-071261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100115760AMedicaid
KS100115760AMedicaid