Provider Demographics
NPI:1356349674
Name:COUNTY OF LANE
Entity type:Organization
Organization Name:COUNTY OF LANE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:DOLL
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:620-397-2809
Mailing Address - Street 1:125 WEST LONG STREET
Mailing Address - Street 2:
Mailing Address - City:DIGHTON
Mailing Address - State:KS
Mailing Address - Zip Code:67839-0943
Mailing Address - Country:US
Mailing Address - Phone:620-397-2809
Mailing Address - Fax:620-397-2185
Practice Address - Street 1:125 WEST LONG STREET
Practice Address - Street 2:
Practice Address - City:DIGHTON
Practice Address - State:KS
Practice Address - Zip Code:67839-0943
Practice Address - Country:US
Practice Address - Phone:620-397-2809
Practice Address - Fax:620-397-2185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-11
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100091440-AMedicaid
KS119952OtherBLUE CROSS/BLUE SHIELD
KS100070800-AOtherHCBS
KS100091440-AMedicaid