Provider Demographics
NPI:1578776589
Name:COUNTY OF OSAGE
Entity Type:Organization
Organization Name:COUNTY OF OSAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:M
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-828-3117
Mailing Address - Street 1:103 E 9TH
Mailing Address - Street 2:
Mailing Address - City:LYNDON
Mailing Address - State:KS
Mailing Address - Zip Code:66451
Mailing Address - Country:US
Mailing Address - Phone:785-828-3117
Mailing Address - Fax:785-828-3848
Practice Address - Street 1:103 E 9TH
Practice Address - Street 2:
Practice Address - City:LYNDON
Practice Address - State:KS
Practice Address - Zip Code:66451
Practice Address - Country:US
Practice Address - Phone:785-828-3117
Practice Address - Fax:785-828-3848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100115830AOtherPUBLIC HEALTH