Provider Demographics
NPI:1689720617
Name:CITY OF SABETHA
Entity Type:Organization
Organization Name:CITY OF SABETHA
Other - Org Name:SABETHA EMERGENCY SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:EMS BILLING
Authorized Official - Prefix:MS
Authorized Official - First Name:PAM
Authorized Official - Middle Name:D
Authorized Official - Last Name:JACKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-284-2158
Mailing Address - Street 1:805 MAIN ST
Mailing Address - Street 2:P.O. BOX 187
Mailing Address - City:SABETHA
Mailing Address - State:KS
Mailing Address - Zip Code:66534-1826
Mailing Address - Country:US
Mailing Address - Phone:785-284-2158
Mailing Address - Fax:
Practice Address - Street 1:1220 OREGON
Practice Address - Street 2:
Practice Address - City:SABETHA
Practice Address - State:KS
Practice Address - Zip Code:66534
Practice Address - Country:US
Practice Address - Phone:785-284-2158
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025474700Medicaid
KS112003OtherBCBS PROVIDER NUMBER
OK200080460AMedicaid