Organization
COUNTY OF WALLACE
Active
Other names
Wallace County Health Department
Organization subpart
No
Provider details
NPI number
Authorized official
TONYA MEDINA ADMINISTRATOR (ADM/RN)
(785) 852-4272
Entity
Organization
Contact information
Practice address
104 E 4TH, SHARON SPRINGS, KS 67758-9715
(785) 852-4272
(785) 852-4249
Mailing address
313 MAIN ST., SHARON SPRINGS, KS 67758
(785) 852-4272
(785) 852-4249
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
0523662
KS
261QP0905X
State or Local Public Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100091770A
—
KS
01
—
1477634301
BCBS
KS
05
—
1477634301
—
KS
Enumeration date
10/18/2006
Last updated
12/23/2024
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