Provider Demographics
NPI:1770586976
Name:COUNTY OF FRANKLIN
Entity type:Organization
Organization Name:COUNTY OF FRANKLIN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:MS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:PFIZENMAIER
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:785-229-3561
Mailing Address - Street 1:1418 S MAIN ST
Mailing Address - Street 2:STE 1
Mailing Address - City:OTTAWA
Mailing Address - State:KS
Mailing Address - Zip Code:66067-3544
Mailing Address - Country:US
Mailing Address - Phone:785-229-3530
Mailing Address - Fax:785-229-3529
Practice Address - Street 1:1418 S MAIN ST
Practice Address - Street 2:STE 1
Practice Address - City:OTTAWA
Practice Address - State:KS
Practice Address - Zip Code:66067-3544
Practice Address - Country:US
Practice Address - Phone:785-229-3530
Practice Address - Fax:785-229-3529
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF FRANKLIN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-05-23
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QP2300X
KS251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS90060Medicaid
KS60090Medicaid
KS00650Medicare ID - Type UnspecifiedMEDICARE