Provider Demographics
NPI:1013952993
Name:BATES COUNTY HEALTH CENTER
Entity type:Organization
Organization Name:BATES COUNTY HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JODY
Authorized Official - Middle Name:
Authorized Official - Last Name:WELSTON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:660-679-6108
Mailing Address - Street 1:501 N ORANGE ST
Mailing Address - Street 2:P.O. BOX 208
Mailing Address - City:BUTLER
Mailing Address - State:MO
Mailing Address - Zip Code:64730-1325
Mailing Address - Country:US
Mailing Address - Phone:660-679-6108
Mailing Address - Fax:660-679-6022
Practice Address - Street 1:501 N ORANGE ST
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:MO
Practice Address - Zip Code:64730-1325
Practice Address - Country:US
Practice Address - Phone:660-679-6108
Practice Address - Fax:660-679-6022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO7726Medicaid
MO7726Medicaid
MO25731011Medicare UPIN