Medco Ambulance Services, LLC

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

1245 Issued in KS

Legal business name

MEDCO AMBULANCE SERVICES, LLC

Practice address

401 S Ida St
Wichita, KS 67211-1511

Phone

(316) 264-3600

NPI assigned

Aug 14, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Derek G Shore

Title

Director

Phone

(316) 264-3600

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189382400000",
    "number": "1437162476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 S IDA ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672111511",
            "telephone_number": "316-264-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 S IDA ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672111511",
            "telephone_number": "316-264-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDCO AMBULANCE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-14",
        "last_updated": "2007-09-10",
        "status": "A",
        "authorized_official_last_name": "SHORE",
        "authorized_official_first_name": "DEREK",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "316-264-3600",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "KS",
            "license": "1245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.