Provider Demographics
NPI:1508395351
Name:COUNTY OF POTTAWATOMIE
Entity Type:Organization
Organization Name:COUNTY OF POTTAWATOMIE
Other - Org Name:COUNTY OF POTTAWATOMIE EMS
Other - Org Type:Other Name
Authorized Official - Title/Position:EMS DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:HAL
Authorized Official - Middle Name:
Authorized Official - Last Name:BUMGARNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-456-9700
Mailing Address - Street 1:PO BOX 310
Mailing Address - Street 2:
Mailing Address - City:WESTMORELAND
Mailing Address - State:KS
Mailing Address - Zip Code:66549-0310
Mailing Address - Country:US
Mailing Address - Phone:785-457-3719
Mailing Address - Fax:785-457-2144
Practice Address - Street 1:406 MILLER DR # F
Practice Address - Street 2:
Practice Address - City:WAMEGO
Practice Address - State:KS
Practice Address - Zip Code:66547-1209
Practice Address - Country:US
Practice Address - Phone:785-456-9700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF POTTAWATOMIE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-06-06
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport