Provider Demographics
NPI:1679544811
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 1:212 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLEY
Mailing Address - State:KS
Mailing Address - Zip Code:67748-1220
Mailing Address - Country:US
Mailing Address - Phone:785-672-3261
Mailing Address - Fax:785-672-8194
Practice Address - Street 1:212 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:OAKLEY
Practice Address - State:KS
Practice Address - Zip Code:67748-1220
Practice Address - Country:US
Practice Address - Phone:785-672-3261
Practice Address - Fax:785-672-8194
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LOGAN COUNTY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-01-27
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
178562OtherMEDICARE RURAL HEALTH CLINIC
KS100296860AMedicaid
KS744OtherRURAL HEALTH BCBS