1265400022 NPI number — COUNTY OF ELLIS

Table of content: (NPI 1265400022)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265400022 NPI number — COUNTY OF ELLIS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNTY OF ELLIS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ELLIS COUNTY EMS
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1265400022
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/12/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1009 CODY AVENUE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HAYS
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
67601
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
785-628-9461
Provider Business Mailing Address Fax Number:
785-628-9464

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1009 CODY AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAYS
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-628-9461
Provider Business Practice Location Address Fax Number:
785-628-9464
Provider Enumeration Date:
03/09/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MCCUE
Authorized Official First Name:
KERRY
Authorized Official Middle Name:
G
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
785-628-9461

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 100113480B , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 119990 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 663510 . This is a "FIRSTGUARD" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 590009831 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".