Provider Demographics
NPI:1841570298
Name:ROOKS COUNTY HEALTH CENTER
Entity Type:Organization
Organization Name:ROOKS COUNTY HEALTH CENTER
Other - Org Name:DOCS WITHOUT DELAY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SINCLAIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-688-4435
Mailing Address - Street 1:PO BOX 407
Mailing Address - Street 2:
Mailing Address - City:PLAINVILLE
Mailing Address - State:KS
Mailing Address - Zip Code:67663-0407
Mailing Address - Country:US
Mailing Address - Phone:785-688-4415
Mailing Address - Fax:785-434-2434
Practice Address - Street 1:1210 N WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:PLAINVILLE
Practice Address - State:KS
Practice Address - Zip Code:67663-1632
Practice Address - Country:US
Practice Address - Phone:785-688-4415
Practice Address - Fax:785-434-2434
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROOKS COUNTY HEALTH CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-08-17
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSH-082-001207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100099310FMedicaid
KS012274Medicare UPIN