Provider Demographics
NPI:1356355903
Name:COUNTY OF RENO
Entity type:Organization
Organization Name:COUNTY OF RENO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/HEALTH OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:A
Authorized Official - Last Name:SELTZER
Authorized Official - Suffix:
Authorized Official - Credentials:RN MS
Authorized Official - Phone:620-694-2900
Mailing Address - Street 1:209 W 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67501-5232
Mailing Address - Country:US
Mailing Address - Phone:620-694-2900
Mailing Address - Fax:620-694-2901
Practice Address - Street 1:209 W 2ND AVE
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67501-5232
Practice Address - Country:US
Practice Address - Phone:620-694-2900
Practice Address - Fax:620-694-2901
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF RENO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-28
Last Update Date:2010-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSA078001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS000285OtherBLUE CROSS BLUE SHIELD PR
KS100089310BMedicaid
KS000285OtherBLUE CROSS BLUE SHIELD PR