Provider Demographics
NPI:1346466737
Name:ATCHISON COUNTY HEALTH CENTER
Entity Type:Organization
Organization Name:ATCHISON COUNTY HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LIVENGOOD
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LD
Authorized Official - Phone:660-736-4121
Mailing Address - Street 1:421 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TARKIO
Mailing Address - State:MO
Mailing Address - Zip Code:64491-1544
Mailing Address - Country:US
Mailing Address - Phone:660-736-4121
Mailing Address - Fax:660-736-5533
Practice Address - Street 1:421 MAIN ST
Practice Address - Street 2:
Practice Address - City:TARKIO
Practice Address - State:MO
Practice Address - Zip Code:64491-1544
Practice Address - Country:US
Practice Address - Phone:660-736-4121
Practice Address - Fax:660-736-5533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO512449505Medicaid