JEFFERSON COUNTY MEMORIAL HOSPITAL NPI 1447660360

NPI Information

NPI: 1447660360
Provider Name: JEFFERSON COUNTY MEMORIAL HOSPITAL

Doing Business As: FW HUSTON MEDICAL CLINIC

Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

CLIA Number: 17D2035956

Address:
504 PLAZA DR
SUITE 300
PERRY, KS
ZIP 66073
Phone: (913) 774-4340
Get Directions

JEFFERSON COUNTY MEMORIAL HOSPITAL is a multi-specialty clinic center in Perry, KS. JEFFERSON COUNTY MEMORIAL HOSPITAL NPI is 1447660360. The provider is registered as an organization entity type.
The provider Is Doing Business As Fw Huston Medical Clinic.

The provider's business location address is:

504 PLAZA DR
SUITE 300
PERRY, KS
ZIP 66073-136
Phone: (913) 774-4340
Fax: (913) 774-3379

The provider's authorized official is Lamont Cook .
The authorized official title is Ceo and has the following contact phone number (913) 774-4340.

The CLIA number assigned to this NPI record is 17D2035956 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/30/2014 and was last updated on 6/23/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM1300X	Clinic/Center	Multi-Specialty			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	100080370F	MEDICAID	KANSAS
2	110046	OTHER	KANSAS	MEDICARE ID-TYPE UNSPECIFIED

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »