Provider Demographics
NPI:1750322988
Name:COUNTY OF ALLEN
Entity Type:Organization
Organization Name:COUNTY OF ALLEN
Other - Org Name:ALLEN COUNTY EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS OFFICE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:A
Authorized Official - Last Name:CALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-365-1432
Mailing Address - Street 1:1 N WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:IOLA
Mailing Address - State:KS
Mailing Address - Zip Code:66749-2835
Mailing Address - Country:US
Mailing Address - Phone:620-365-1432
Mailing Address - Fax:620-365-1455
Practice Address - Street 1:1 N WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:IOLA
Practice Address - State:KS
Practice Address - Zip Code:66749-2835
Practice Address - Country:US
Practice Address - Phone:620-365-1432
Practice Address - Fax:620-365-1455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-09
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100324450AMedicaid
KS112006OtherBLUE CROSS/BLUE SHIELD
KS112006Medicare ID - Type Unspecified