Provider Demographics
NPI:1336146034
Name:COUNTY OF HARPER
Entity Type:Organization
Organization Name:COUNTY OF HARPER
Other - Org Name:HARPER COUNTY HOME HEALTH AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:HOUSTON
Authorized Official - Suffix:
Authorized Official - Credentials:LBSW
Authorized Official - Phone:620-842-5132
Mailing Address - Street 1:PO BOX 66
Mailing Address - Street 2:
Mailing Address - City:ANTHONY
Mailing Address - State:KS
Mailing Address - Zip Code:67003-0066
Mailing Address - Country:US
Mailing Address - Phone:620-842-5132
Mailing Address - Fax:
Practice Address - Street 1:123 N JENNINGS AVE
Practice Address - Street 2:
Practice Address - City:ANTHONY
Practice Address - State:KS
Practice Address - Zip Code:67003-2708
Practice Address - Country:US
Practice Address - Phone:620-842-5132
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-07
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSA039001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS0272OtherBCBS PROVIDER #
KS100089350BMedicaid
KS177023Medicare ID - Type UnspecifiedMEDICARE PROVIDER #