1265418396 NPI number — OLATHE FIRE PROTECTION DISTRICT EMS

Table of content: (NPI 1265418396)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265418396 NPI number — OLATHE FIRE PROTECTION DISTRICT EMS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OLATHE FIRE PROTECTION DISTRICT EMS
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:
OLATHE FIRE PROTECTION DISTRICT
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:
1265418396
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/30/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1192
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MONTROSE
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
81402-1192
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
970-323-6234
Provider Business Mailing Address Fax Number:
970-323-8714

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
406 S. 5TH STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OLATHE
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
81425
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
970-323-6234
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/20/2005

Additional Information

Authorized Official

Authorized Official Last Name:
GRAY
Authorized Official First Name:
CHRISTINE
Authorized Official Middle Name:
C
Authorized Official Title or Position:
DISTRICT ADMINISTRATOR
Authorized Official Telephone Number:
970-323-6234

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  9808804 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: P00165727 . This is a "RAILROAD WORKERS MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 83633375 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".




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