Provider Demographics
NPI:1841372414
Name:NEOSHO COUNTY
Entity type:Organization
Organization Name:NEOSHO COUNTY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:K
Authorized Official - Last Name:STARR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-431-5770
Mailing Address - Street 1:320 E MAIN
Mailing Address - Street 2:
Mailing Address - City:CHANUTE
Mailing Address - State:KS
Mailing Address - Zip Code:66720
Mailing Address - Country:US
Mailing Address - Phone:620-431-5770
Mailing Address - Fax:620-431-5772
Practice Address - Street 1:320 E MAIN
Practice Address - Street 2:
Practice Address - City:CHANUTE
Practice Address - State:KS
Practice Address - Zip Code:66720
Practice Address - Country:US
Practice Address - Phone:620-431-5770
Practice Address - Fax:620-431-5772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2014-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1372830021163W00000X
KS1381187091163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS000005112OtherFIRSTGUARD
KS100115690AMedicaid
KS000005112OtherFIRSTGUARD