Provider Demographics
NPI:1346347796
Name:COUNTY OF KEARNY
Entity Type:Organization
Organization Name:COUNTY OF KEARNY
Other - Org Name:KEARNY COUNTY EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EMERGENCY MEDICAL TECHNICIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:R
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:EMT-I
Authorized Official - Phone:620-355-1386
Mailing Address - Street 1:614 HAROLDS PLACE
Mailing Address - Street 2:
Mailing Address - City:LAKIN
Mailing Address - State:KS
Mailing Address - Zip Code:67860
Mailing Address - Country:US
Mailing Address - Phone:620-355-1386
Mailing Address - Fax:620-355-7396
Practice Address - Street 1:614 HAROLDS PLACE
Practice Address - Street 2:
Practice Address - City:LAKIN
Practice Address - State:KS
Practice Address - Zip Code:67860
Practice Address - Country:US
Practice Address - Phone:620-355-1386
Practice Address - Fax:620-355-7396
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2009-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS9403416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100092040BMedicaid
KS005770OtherBLUE CROSS & BLUE SHIELD
KS100092040BMedicaid