Provider Demographics
NPI:1437241882
Name:COUNTY OF GOVE
Entity Type:Organization
Organization Name:COUNTY OF GOVE
Other - Org Name:GOVE COUNTY HEALTH DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:GOETZ
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:785-938-2335
Mailing Address - Street 1:520 WASHINGTON STREET
Mailing Address - Street 2:SUITE 104
Mailing Address - City:GOVE
Mailing Address - State:KS
Mailing Address - Zip Code:67736
Mailing Address - Country:US
Mailing Address - Phone:785-938-2335
Mailing Address - Fax:785-938-2336
Practice Address - Street 1:520 WASHINGTON STREET
Practice Address - Street 2:SUITE 104
Practice Address - City:GOVE
Practice Address - State:KS
Practice Address - Zip Code:67736
Practice Address - Country:US
Practice Address - Phone:785-938-2335
Practice Address - Fax:785-938-2336
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF GOVE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-29
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100113930AMedicaid
KS500370OtherFIRSTGUARD
KS012798OtherBLUECROSSBLUESHIELD
KS90060OtherFIRSTGUARD (HEALTHWAVE)
KS600000408Medicare ID - Type UnspecifiedRAILROAD MEDICARE
KS90060OtherFIRSTGUARD (HEALTHWAVE)
KS012798OtherBLUECROSSBLUESHIELD