Provider Demographics
NPI:1780934927
Name:COUNTY OF LOGAN
Entity type:Organization
Organization Name:COUNTY OF LOGAN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOEE
Authorized Official - Middle Name:SHANE
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-672-1409
Mailing Address - Street 1:175 S RANGE AVE
Mailing Address - Street 2:
Mailing Address - City:COLBY
Mailing Address - State:KS
Mailing Address - Zip Code:67701-2931
Mailing Address - Country:US
Mailing Address - Phone:785-462-3332
Mailing Address - Fax:
Practice Address - Street 1:175 S RANGE AVE
Practice Address - Street 2:
Practice Address - City:COLBY
Practice Address - State:KS
Practice Address - Zip Code:67701-2931
Practice Address - Country:US
Practice Address - Phone:785-462-3332
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LOGAN COUNTY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-09-14
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Single Specialty