Organization
JEFFERSON COUNTY MEMORIAL HOSPITAL, INC
Active
Organization
JEFFERSON COUNTY MEMORIAL HOSPITAL, INC
Active
Other names
FW Huston Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
JASON JOHNSON (CFO)
(913) 933-4020
Entity
Organization
Contact information
Practice address
15630 PINEHURST DR, SUITE 5, BASEHOR, KS 66007-8233
(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 ID TYPE UNSPECIFIED
KS
Enumeration date
08/13/2015
Last updated
03/27/2023
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