# COFFEY COUNTY HOSPITAL LTC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** COFFEY COUNTY HOSPITAL
- **Other names:** Sunset Manor
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1073603825
- **Legal business name:** COFFEY COUNTY HOSPITAL
- **Authorized official:** MERRI MICHAELS (BILLING SUPERVISOR)
- **Authorized official phone:** (620) 364-2121

## Contact information

- **Practice address:** 128 S PEARSON AVENUE, WAVERLY, KS 66871
- **Practice address phone:** (785) 733-2744
- **Practice address fax:** (785) 733-2514
- **Mailing address:** 801 N 4TH ST, BURLINGTON, KS 66839-2602
- **Mailing address phone:** (620) 364-2121
- **Mailing address fax:** (620) 364-8425

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | — | KS | Yes |

## Other

- **Enumeration date:** 10/13/2006
- **Last updated:** 01/15/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100110550A | — | KS |