1851473235 NPI number — COUNTY OF FORD

Table of content: (NPI 1851473235)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851473235 NPI number — COUNTY OF FORD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNTY OF FORD
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:
FORD 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:
1851473235
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/07/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 48339
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WICHITA
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
67201-8339
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
316-685-6161
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 GUNSMOKE ST
Provider Second Line Business Practice Location Address:
BOX 7
Provider Business Practice Location Address City Name:
DODGE CITY
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67801-4456
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
620-227-4558
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/19/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GOODNIGHT
Authorized Official First Name:
T
Authorized Official Middle Name:
CHRIS
Authorized Official Title or Position:
COMMISSION CHAIR
Authorized Official Telephone Number:
620-227-6465

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  610 , 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: 590496178 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5965077 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100092730B , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".