County of Logan
Organization Active NPI Ambulance · Oakley, KS
NPI 1205899499 · NPPES record last updated May 20, 2024
Key facts
- NPI
- 1205899499
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulance 341600000X
- License
- 1120 (KS)
- Legal business name
- COUNTY OF LOGAN
- Practice address
- 703 W 3Rd St
Oakley, KS 67748-1269 - Phone
- (785) 671-0031
- Fax
- (785) 671-0031
- NPI assigned
- Apr 9, 2006
- Organization subpart
- No
Authorized official
- Name
- Robert Kelly Jr.
- Title
- Director
- Phone
- (785) 672-1027
Owned or controlled facilities with NPI records 1
Other NPIs with the same Medicare PAC ID 1
Corporate family (same tax ID) 2
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 17D2129569 | Logan County EMS | Certificate of waiver | Apr 20, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| Reliant Pro Rehab |
Skilled nursing facility | Adp of the SNF | Jul 1, 2020 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120321000641 | KS | Part B Supplier - Ambulance Service Supplier | 3476500620 | Practice locations: Oakley, KS |
National Provider Directory
- Tax ID family
- County of Logan
Locations
710 W 2nd St
Oakley, KS 67748
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | 1120 | KS | Yes |
Addresses
Primary practice location
703 W 3Rd St
Oakley, KS 67748-1269
Mailing address
710 W 2ND St
Oakley, KS 67748-1271
Phone (785) 672-1027
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100091660B | Medicaid | KS |
Other names
- Logan County Emergency Medical Service
Other providers in Oakley, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 20, 2024. 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.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- 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.