Provider Demographics
NPI:1003152430
Name:RURAL HEALTH RESOURCES OF JACKSON CO INC
Entity type:Organization
Organization Name:RURAL HEALTH RESOURCES OF JACKSON CO INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:SAIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-364-2116
Mailing Address - Street 1:1110 COLUMBINE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:HOLTON
Mailing Address - State:KS
Mailing Address - Zip Code:66436-8824
Mailing Address - Country:US
Mailing Address - Phone:785-364-2126
Mailing Address - Fax:785-364-2801
Practice Address - Street 1:323 2ND ST
Practice Address - Street 2:
Practice Address - City:WETMORE
Practice Address - State:KS
Practice Address - Zip Code:66550-9618
Practice Address - Country:US
Practice Address - Phone:785-866-4775
Practice Address - Fax:785-866-4204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-12
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS178575Medicare Oscar/Certification