1770531519 NPI number — CITY OF HIGGINSVILLE

Table of content: (NPI 1770531519)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770531519 NPI number — CITY OF HIGGINSVILLE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY OF HIGGINSVILLE
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:
HIGGINSVILLE EMERGENCY MEDICAL SERVICES
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:
1770531519
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/14/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 781621
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:
67278-1621
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
855-626-9660
Provider Business Mailing Address Fax Number:
833-953-0588

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
211 W 19TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HIGGINSVILLE
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64037-1510
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
660-584-6780
Provider Business Practice Location Address Fax Number:
660-584-3663
Provider Enumeration Date:
05/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
KENNEY
Authorized Official First Name:
DOUGLAS
Authorized Official Middle Name:
W
Authorized Official Title or Position:
EMS DIRECTOR
Authorized Official Telephone Number:
660-584-2106

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  107018 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 124351 . This is a "HEALTHLINK" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 03431012 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 590077713 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 008990 . This is a "FAMILY HEALTH PARTNERS" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 800549016 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 306130 . This is a "FIRST GUARD" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 4020637 . This is a "BCBS OF TENNESSEE" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".




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