Provider Demographics
NPI:1801290093
Name:NORTHEAST KANSAS MULTI-COUNTY HEALTH DEPARTMENTS, INC.
Entity type:Organization
Organization Name:NORTHEAST KANSAS MULTI-COUNTY HEALTH DEPARTMENTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATIONS OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:ROMINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-742-7192
Mailing Address - Street 1:907 S 2ND ST
Mailing Address - Street 2:P.O. BOX 182
Mailing Address - City:HIAWATHA
Mailing Address - State:KS
Mailing Address - Zip Code:66434-2774
Mailing Address - Country:US
Mailing Address - Phone:785-742-7192
Mailing Address - Fax:785-742-4237
Practice Address - Street 1:907 S 2ND ST
Practice Address - Street 2:
Practice Address - City:HIAWATHA
Practice Address - State:KS
Practice Address - Zip Code:66434-2774
Practice Address - Country:US
Practice Address - Phone:785-742-7192
Practice Address - Fax:785-742-4237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-16
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSKSA007001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS00280OtherBLUE CROSS BLUE SHIELD OF KANSAS
KS100089330BMedicaid
KS00280OtherBLUE CROSS BLUE SHIELD OF KANSAS