Organization
JEFFERSON COUNTY MEMORIAL HOSPITAL
Active
Other names
Jefferson Medical Urgent Care
Organization subpart
No
Provider details
NPI number
Authorized official
LAMONT COOK (CEO)
(913) 774-4340
Entity
Organization
Contact information
Practice address
408 DELAWARE ST, WINCHESTER, KS 66097-4003
(913) 774-4340
(913) 774-3379
Mailing address
408 DELAWARE ST, WINCHESTER, KS 66097-4003
(913) 774-4340
(913) 774-3379
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
H044001
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100080370F
—
KS
01
—
110046
MEDICARE
KS
Enumeration date
02/15/2016
Last updated
02/15/2016
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