Provider Demographics
NPI: | 1295075851 |
---|---|
Name: | MEALS ON WHEELS OF BARTON COUNTY |
Entity type: | Organization |
Organization Name: | MEALS ON WHEELS OF BARTON COUNTY |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | EXECUTIVE DIRECTOR |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | DONNA |
Authorized Official - Middle Name: | H |
Authorized Official - Last Name: | BAUGH |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 620-792-1833 |
Mailing Address - Street 1: | 1025 MAIN ST # D114 |
Mailing Address - Street 2: | |
Mailing Address - City: | GREAT BEND |
Mailing Address - State: | KS |
Mailing Address - Zip Code: | 67530-4429 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 620-792-1833 |
Mailing Address - Fax: | 620-793-7689 |
Practice Address - Street 1: | 1025 MAIN ST # D114 |
Practice Address - Street 2: | |
Practice Address - City: | GREAT BEND |
Practice Address - State: | KS |
Practice Address - Zip Code: | 67530-4429 |
Practice Address - Country: | US |
Practice Address - Phone: | 620-792-1833 |
Practice Address - Fax: | 620-793-7689 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2013-02-19 |
Last Update Date: | 2013-02-19 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 251V00000X | Agencies | Voluntary or Charitable |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
KS | 200738350A | Medicaid |