Provider Demographics
NPI:1891845475
Name:LABETTE COUNTY MEDICAL CENTER
Entity Type:Organization
Organization Name:LABETTE COUNTY MEDICAL CENTER
Other - Org Name:LABETTE HEALTH PHYSICIAN'S GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:SOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-820-5254
Mailing Address - Street 1:1902 S US HIGHWAY 59
Mailing Address - Street 2:
Mailing Address - City:PARSONS
Mailing Address - State:KS
Mailing Address - Zip Code:67357-4948
Mailing Address - Country:US
Mailing Address - Phone:620-820-5428
Mailing Address - Fax:620-820-5274
Practice Address - Street 1:1902 S US HIGHWAY 59
Practice Address - Street 2:
Practice Address - City:PARSONS
Practice Address - State:KS
Practice Address - Zip Code:67357-4948
Practice Address - Country:US
Practice Address - Phone:620-421-4880
Practice Address - Fax:620-820-5274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS111295Medicare PIN
KSCK3451Medicare PIN