| Dba Leavenworth County Health Department | |
|
500 Eisenhower Rd. Suite 101 Leavenworth KS 66048-4969 | |
| (913) 250-2000 | |
| (913) 250-2039 |
| Full Name | Dba Leavenworth County Health Department |
|---|---|
| Speciality | Clinic/Center |
| Location | 500 Eisenhower Rd., Leavenworth, Kansas |
| Authorized Official Name and Position | Jamie A. Miller (DIRECTOR HEALTH DEPARTMENT) |
| Authorized Official Contact | 9132502006 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dba Leavenworth County Health Department 500 Eisenhower Rd. Suite 101 Leavenworth KS 66048-4969 Ph: (913) 250-2000 | Dba Leavenworth County Health Department 500 Eisenhower Rd. Suite 101 Leavenworth KS 66048-4969 Ph: (913) 250-2000 |
| NPI Number | 1174540256 |
|---|---|
| Provider Enumeration Date | 07/16/2006 |
| Last Update Date | 03/29/2013 |
| Medicare PECOS PAC ID | 9739126533 |
|---|---|
| Medicare Enrollment ID | O20130625000322 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174540256 | NPI | - | NPPES |
| 630050 | Medicaid | KS | |
| 100091480A | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP0905X | Clinic/center - Public Health, State Or Local | (* (Not Available)) | Primary |
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