1821044991 NPI number — COUNTY OF SHERIDAN

Table of content: (NPI 1821044991)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821044991 NPI number — COUNTY OF SHERIDAN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNTY OF SHERIDAN
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:
SHERIDAN 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:
1821044991
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/27/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1717 OAK AVE
Provider Second Line Business Mailing Address:
RT 1 BOX 941
Provider Business Mailing Address City Name:
HOXIE
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
67740-4188
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
785-675-3364
Provider Business Mailing Address Fax Number:
785-675-3367

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1717 OAK AVE
Provider Second Line Business Practice Location Address:
RT 1 BOX 941
Provider Business Practice Location Address City Name:
HOXIE
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67740-4188
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-675-3364
Provider Business Practice Location Address Fax Number:
785-675-3367
Provider Enumeration Date:
05/26/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
KAUFMAN
Authorized Official First Name:
DEBORAH
Authorized Official Middle Name:
E
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
785-675-3364

Provider Taxonomy Codes

  • Taxonomy code: 146M00000X , with the licence number:  1790 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 146N00000X , with the licence number: 1790 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 100070770A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".