City of Ellinwood
Organization Active NPI Basic Emergency Medical Technician · Ellinwood, KS
NPI 1679567721 · NPPES record last updated Jul 7, 2008
Key facts
- NPI
- 1679567721
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Basic Emergency Medical Technician 146N00000X
- License
- 550 (KS)
- Legal business name
- CITY OF ELLINWOOD
- Practice address
- 104 E 2ND St
Ellinwood, KS 67526-1627 - Phone
- (620) 564-2408
- Fax
- (620) 564-2401
- NPI assigned
- Sep 6, 2005
- Organization subpart
- No
Authorized official
- Name
- Ms. Debbie M. Glenn, NREMT-P
- Title
- EMS Director
- Phone
- (620) 564-2408
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080725000746 | KS | Part B Supplier - Ambulance Service Supplier | 5991878720 | Practice locations: Ellinwood, KS |
National Provider Directory
Locations
209 W 1st St
Ellinwood, KS 67526
Phone (316) 564-3161
104 E 2nd St
Ellinwood, KS 67526
Phone (620) 564-2408
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Basic Emergency Medical Technician |
146N00000X | 550 | KS | Yes |
Addresses
Primary practice location
104 E 2ND St
Ellinwood, KS 67526-1627
Mailing address
PO Box 278
Ellinwood, KS 67526-0278
Phone (620) 564-2408
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100092010-A | Medicaid | KS |
Other providers in Ellinwood, KS
- Advanced Practice Specialties, LLC
- Christopher M Brown
- Stacy Lynn Clawson
- Mallory Lynn Damon
- Dan Leroy Davis
- Diversicare of Ellinwood, LLC
- Robin D Durrett
All providers in Ellinwood, KS · Basic Emergency Medical Technician in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 7, 2008. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.