Provider Demographics
NPI:1841394236
Name:CITY OF MILTONVALE
Entity Type:Organization
Organization Name:CITY OF MILTONVALE
Other - Org Name:MILTONVALE AMBULANCE SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CITY CLERK
Authorized Official - Prefix:
Authorized Official - First Name:DARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:BEBBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-427-3380
Mailing Address - Street 1:PO BOX 248
Mailing Address - Street 2:
Mailing Address - City:MILTONVALE
Mailing Address - State:KS
Mailing Address - Zip Code:67466-0248
Mailing Address - Country:US
Mailing Address - Phone:785-427-3380
Mailing Address - Fax:785-427-3390
Practice Address - Street 1:107 STARR AVENUE
Practice Address - Street 2:
Practice Address - City:MILTONVALE
Practice Address - State:KS
Practice Address - Zip Code:67466
Practice Address - Country:US
Practice Address - Phone:785-427-3380
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-07
Last Update Date:2012-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1300341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100091890AMedicaid
KS100091890AMedicaid
KS100091890AMedicaid