Provider Demographics
NPI:1497749774
Name:COUNTY OF MITCHELL
Entity Type:Organization
Organization Name:COUNTY OF MITCHELL
Other - Org Name:MITCHELL COUNTY HEALTH DEPARTMENT/NORTH CENTRAL KANSAS HOME HEALTH AGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:DOWLIN
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, RN
Authorized Official - Phone:785-738-5175
Mailing Address - Street 1:310 W 8TH ST
Mailing Address - Street 2:
Mailing Address - City:BELOIT
Mailing Address - State:KS
Mailing Address - Zip Code:67420-1603
Mailing Address - Country:US
Mailing Address - Phone:785-738-5175
Mailing Address - Fax:785-738-5053
Practice Address - Street 1:310 W 8TH ST
Practice Address - Street 2:
Practice Address - City:BELOIT
Practice Address - State:KS
Practice Address - Zip Code:67420-1603
Practice Address - Country:US
Practice Address - Phone:785-738-5175
Practice Address - Fax:785-738-5053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-01
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSA-062-001251E00000X
251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
642600OtherFIRSTGUARD HEALTH PLAN
KS10001500AMedicaid
KS100092270AMedicaid
00539OtherBC/BS HOME HEALTH
KS012755OtherBLUE CROSS/BLUE SHIELD
KS100092270BMedicaid
11477OtherPREFERRED HEALTH SYSTEMS
KS177071Medicare ID - Type UnspecifiedMEDICARE CERTIFIED
012755Medicare ID - Type UnspecifiedMEDICARE PART B
KS100092270BMedicaid