Provider Demographics
NPI:1932191848
Name:COUNTY OF RUSH
Entity Type:Organization
Organization Name:COUNTY OF RUSH
Other - Org Name:RUSH COUNTY HEALTH DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COUNTY COMMISSIONER
Authorized Official - Prefix:MR
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:
Authorized Official - Last Name:MASTRONI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-222-2728
Mailing Address - Street 1:611 PEACE ST
Mailing Address - Street 2:
Mailing Address - City:LA CROSSE
Mailing Address - State:KS
Mailing Address - Zip Code:67548
Mailing Address - Country:US
Mailing Address - Phone:785-222-3427
Mailing Address - Fax:785-222-3593
Practice Address - Street 1:611 PEACE ST
Practice Address - Street 2:
Practice Address - City:LA CROSSE
Practice Address - State:KS
Practice Address - Zip Code:67548
Practice Address - Country:US
Practice Address - Phone:785-222-3427
Practice Address - Fax:785-222-3593
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-17
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS140A073T999251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100113320AMedicaid
KS629650OtherFIRSTGUARD
KS000012749OtherBLUE CROSS BLUE SHIELD
KS100113320AMedicaid