Provider Demographics
NPI:1750489555
Name:COUNTY OF STEVENS
Entity Type:Organization
Organization Name:COUNTY OF STEVENS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:M
Authorized Official - Last Name:ROWDEN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:620-544-7177
Mailing Address - Street 1:1042 S JACKSON ST STE A
Mailing Address - Street 2:
Mailing Address - City:HUGOTON
Mailing Address - State:KS
Mailing Address - Zip Code:67951-2842
Mailing Address - Country:US
Mailing Address - Phone:620-544-7177
Mailing Address - Fax:620-544-2006
Practice Address - Street 1:1042 S JACKSON ST STE A
Practice Address - Street 2:
Practice Address - City:HUGOTON
Practice Address - State:KS
Practice Address - Zip Code:67951-2842
Practice Address - Country:US
Practice Address - Phone:620-544-7177
Practice Address - Fax:620-544-2006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100243570BMedicaid
KS119972OtherBCBS PROVIDER NUMBER
KS119972OtherBCBS PROVIDER NUMBER