County of Clay
Organization Active NPI Ambulance · Clay Center, KS
NPI 1124192901 · NPPES record last updated Mar 8, 2012
Key facts
- NPI
- 1124192901
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulance 341600000X
- License
- 350 (KS)
- Legal business name
- COUNTY OF CLAY
- Practice address
- 603 4TH St
Clay Center, KS 67432 - Phone
- (785) 632-2166
- Fax
- (785) 632-6050
- NPI assigned
- Nov 20, 2006
- Organization subpart
- No
Authorized official
- Name
- Ms. Patsy Jo Charest, EMTI
- Title
- Assistant Director
- Phone
- (785) 632-2166
Other NPIs with the same Medicare PAC ID 1
Corporate family (same tax ID) 1
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 17D2108873 | Clay County Emergency Medical Services | Certificate of waiver | Feb 14, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120309000042 | KS | Part B Supplier - Ambulance Service Supplier | 4587576533 | Practice locations: Clay Center, KS |
National Provider Directory
- Tax ID family
- County of Clay
Locations
603 4th St
Clay Center, KS 67432
Phone (785) 632-2166
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | 350 | KS | Yes |
Addresses
Primary practice location
603 4TH St
Clay Center, KS 67432
Mailing address
603 4TH St
Clay Center, KS 67432
Phone (785) 632-2166
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 005656 | Other | BCBS | |
| 100115070C | Medicaid | KS |
Other names
- Clay County Ambulance Service
Other providers in Clay Center, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 8, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.