Provider Demographics
NPI:1629034814
Name:CITY OF JUNCTION CITY
Entity Type:Organization
Organization Name:CITY OF JUNCTION CITY
Other - Org Name:JUNCTION CITY FIRE DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FIRE/EMS CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-238-6822
Mailing Address - Street 1:700 N JEFFERSON ST
Mailing Address - Street 2:P O BOX 287
Mailing Address - City:JUNCTION CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66441-3598
Mailing Address - Country:US
Mailing Address - Phone:785-238-6822
Mailing Address - Fax:785-762-3684
Practice Address - Street 1:700 N JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:JUNCTION CITY
Practice Address - State:KS
Practice Address - Zip Code:66441-2979
Practice Address - Country:US
Practice Address - Phone:785-238-6822
Practice Address - Fax:785-762-3684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-25
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS910146L00000X, 146M00000X, 146N00000X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, ParamedicGroup - Single Specialty
No146M00000XEmergency Medical Service ProvidersEmergency Medical Technician, IntermediateGroup - Single Specialty
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, BasicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100091910AMedicaid
KS005706Medicare PIN