Provider Demographics
NPI:1356345888
Name:COFFEY COUNTY MEDICAL CENTER
Entity type:Organization
Organization Name:COFFEY COUNTY MEDICAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:ATKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-625-3647
Mailing Address - Street 1:1004 E MADISON ST
Mailing Address - Street 2:
Mailing Address - City:YATES CENTER
Mailing Address - State:KS
Mailing Address - Zip Code:66783-1314
Mailing Address - Country:US
Mailing Address - Phone:620-625-2312
Mailing Address - Fax:620-625-3560
Practice Address - Street 1:1004 E MADISON ST
Practice Address - Street 2:
Practice Address - City:YATES CENTER
Practice Address - State:KS
Practice Address - Zip Code:66783-1314
Practice Address - Country:US
Practice Address - Phone:620-625-2312
Practice Address - Fax:620-625-3560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS022462Medicare ID - Type Unspecified