Jefferson County Memorial Hospital
Organization Active NPI Multi-Specialty Clinic/Center · Valley Falls, KS
NPI 1265739288 · NPPES record last updated Dec 4, 2014
Key facts
- NPI
- 1265739288
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Multi-Specialty Clinic/Center 261QM1300X
- Legal business name
- JEFFERSON COUNTY MEMORIAL HOSPITAL
- Practice address
- 409 Broadway St
Valley Falls, KS 66088-1303 - Phone
- (913) 774-4340
- Fax
- (913) 774-3379
- NPI assigned
- Feb 28, 2011
- Organization subpart
- No
Authorized official
- Name
- Lamont Cook
- Title
- Ceo
- Phone
- (913) 774-4340
Other NPIs on the same Medicare enrollment 4
Practitioners 1
-
Mary L Rardin, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050215000085 | KS | Part B Supplier - Clinic/Group Practice | 6002868445 |
Receives reassigned benefits from 10 practitioners 4 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Winchester, KS; Basehor, KS |
National Provider Directory
Locations
409 Broadway St
Valley Falls, KS 66088
Phone (913) 774-4340
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Multi-Specialty Clinic/Center | 261QM1300X | KS | Yes |
Addresses
Primary practice location
409 Broadway St
Valley Falls, KS 66088-1303
Mailing address
408 Delaware St
Winchester, KS 66097-4003
Phone (913) 774-4340
Other names
- Jefferson Medical Clinic Valley Falls
Other providers in Valley Falls, KS
- Dr Bruce L Tillery DDS PA
- Farr Chiropractic Clinic, P.a.
- Stanley J Farr
- Janet Dight, PH.D., LLC
- Jefferson County Fire Dist # 11
- Crystal Dawn Kay
- Jamie Marie Kester
- Kollhoff Family Pharmacy LLC
- Mary Miller
- Debbie Ann Name
All providers in Valley Falls, KS · Multi-Specialty Clinic/Center in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 4, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.