Provider Demographics
NPI:1114993797
Name:COUNTY OF PRATT
Entity Type:Organization
Organization Name:COUNTY OF PRATT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASST. DIRECTOR PRATT CO. EMS
Authorized Official - Prefix:
Authorized Official - First Name:KIRK
Authorized Official - Middle Name:C
Authorized Official - Last Name:BRANAMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-672-3863
Mailing Address - Street 1:1001 E 1ST ST
Mailing Address - Street 2:
Mailing Address - City:PRATT
Mailing Address - State:KS
Mailing Address - Zip Code:67124-2055
Mailing Address - Country:US
Mailing Address - Phone:620-672-3863
Mailing Address - Fax:620-672-6960
Practice Address - Street 1:1001 E 1ST ST
Practice Address - Street 2:
Practice Address - City:PRATT
Practice Address - State:KS
Practice Address - Zip Code:67124-2055
Practice Address - Country:US
Practice Address - Phone:620-672-3863
Practice Address - Fax:620-672-6960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-24
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS15703416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100092100CMedicaid
KS005799Medicare ID - Type Unspecified