Provider Demographics
NPI:1790748275
Name:COUNTY OF DECATUR
Entity Type:Organization
Organization Name:COUNTY OF DECATUR
Other - Org Name:DECATUR COUNTY AMBULANCE SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EMT BILLING SECRETARY
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:G
Authorized Official - Last Name:ESKEW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-475-8126
Mailing Address - Street 1:120 E HALL ST
Mailing Address - Street 2:
Mailing Address - City:OBERLIN
Mailing Address - State:KS
Mailing Address - Zip Code:67749-2327
Mailing Address - Country:US
Mailing Address - Phone:785-475-8126
Mailing Address - Fax:785-475-8130
Practice Address - Street 1:120 E HALL ST
Practice Address - Street 2:
Practice Address - City:OBERLIN
Practice Address - State:KS
Practice Address - Zip Code:67749-2327
Practice Address - Country:US
Practice Address - Phone:785-475-8126
Practice Address - Fax:785-475-8130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-07
Last Update Date:2012-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS470341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS005641OtherBLUE CROSS BLUE SHIELD
KS005641Medicare ID - Type Unspecified