Basic Information
| Provider Information | |||||||||
| NPI: | 1750887972 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MIAMI COUNTY MEDICAL CENTER INC. | ||||||||
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| OtherOrganizationName: | OLATHE HEALTH FAMILY MEDICINE-LOUISBURG | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2100 BAPTISTE DR | ||||||||
| Address2: | |||||||||
| City: | PAOLA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 660711314 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9132942327 | ||||||||
| FaxNumber: | 9132949897 | ||||||||
| Practice Location | |||||||||
| Address1: | 102 CRESTVIEW CIR | ||||||||
| Address2: | |||||||||
| City: | LOUISBURG | ||||||||
| State: | KS | ||||||||
| PostalCode: | 660534087 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9138374299 | ||||||||
| FaxNumber: | 9138374162 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/05/2018 | ||||||||
| LastUpdateDate: | 04/05/2018 | ||||||||
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| AuthorizedOfficialLastName: | WIENS | ||||||||
| AuthorizedOfficialFirstName: | CATHERINE | ||||||||
| AuthorizedOfficialMiddleName: | R. | ||||||||
| AuthorizedOfficialTitleorPosition: | VP/QUALITY & COMPLIANCE | ||||||||
| AuthorizedOfficialTelephone: | 9137914459 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | MIAMI COUNTY MEDICAL CENTER INC. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR1300X | Y | Ambulatory Health Care Facilities | Clinic/Center | Rural Health |
No ID Information.