Provider Demographics
NPI:1790710416
Name:MEADE COUNTY
Entity Type:Organization
Organization Name:MEADE COUNTY
Other - Org Name:MEADE COUNTY HEALTH DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:K
Authorized Official - Last Name:JOHANNSEN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:620-873-8745
Mailing Address - Street 1:PO BOX 248
Mailing Address - Street 2:309 S WEBB
Mailing Address - City:MEADE
Mailing Address - State:KS
Mailing Address - Zip Code:67864-0248
Mailing Address - Country:US
Mailing Address - Phone:620-873-8745
Mailing Address - Fax:620-873-8749
Practice Address - Street 1:309 S WEBB
Practice Address - Street 2:
Practice Address - City:MEADE
Practice Address - State:KS
Practice Address - Zip Code:67864-0248
Practice Address - Country:US
Practice Address - Phone:620-873-8745
Practice Address - Fax:620-873-8749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100117560AMedicaid
KS5067OtherFIRST GUARD
KS012799OtherBLUECROSSBLUESHIELD OF KS
KS5067OtherFIRST GUARD