Organization
COUNTY OF CHAUTAUQUA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LINDA D. MCNOWN (ASST. ADMINISTRATOR)
(620) 725-5850
Entity
Organization
Contact information
Practice address
215 N CHAUTAUQUA ST, SEDAN, KS 67361-1326
(620) 725-5850
(620) 725-5856
Mailing address
215 N CHAUTAUQUA ST, SEDAN, KS 67361-1326
(620) 725-5850
(620) 725-5856
Taxonomy
Speciality
Code
Description
License number
State
261QP0905X
State or Local Public Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
013290
BLUE CROSS-BLUE SHIELD
KS
05
—
100114370A
—
KS
Enumeration date
02/27/2007
Last updated
09/16/2013
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