Provider Demographics
NPI:1437267523
Name:CITY OF AXTELL
Entity Type:Organization
Organization Name:CITY OF AXTELL
Other - Org Name:CITY OF AXTELL AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CITY CLERK
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:BUESSING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-736-2834
Mailing Address - Street 1:306 MAPLE ST
Mailing Address - Street 2:P.O. BOX A
Mailing Address - City:AXTELL
Mailing Address - State:KS
Mailing Address - Zip Code:66403-9717
Mailing Address - Country:US
Mailing Address - Phone:785-736-2834
Mailing Address - Fax:785-736-2716
Practice Address - Street 1:306 MAPLE ST
Practice Address - Street 2:P.O. BOX A
Practice Address - City:AXTELL
Practice Address - State:KS
Practice Address - Zip Code:66403-9717
Practice Address - Country:US
Practice Address - Phone:785-736-2834
Practice Address - Fax:785-736-2716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-28
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS110341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100091820AMedicaid
KS019035Medicare ID - Type Unspecified