Provider Demographics
NPI:1205299120
Name:CLAY COUNTY MEDICAL CENTER
Entity type:Organization
Organization Name:CLAY COUNTY MEDICAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:AUSTIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:GILLARD
Authorized Official - Suffix:
Authorized Official - Credentials:MHA
Authorized Official - Phone:785-632-2144
Mailing Address - Street 1:PO BOX 512
Mailing Address - Street 2:
Mailing Address - City:CLAY CENTER
Mailing Address - State:KS
Mailing Address - Zip Code:67432-0512
Mailing Address - Country:US
Mailing Address - Phone:785-632-2144
Mailing Address - Fax:
Practice Address - Street 1:609 LIBERTY ST
Practice Address - Street 2:
Practice Address - City:CLAY CENTER
Practice Address - State:KS
Practice Address - Zip Code:67432-1564
Practice Address - Country:US
Practice Address - Phone:785-632-2181
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-29
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service