Provider Demographics
NPI:1902861487
Name:CITY OF CONWAY SPRINGS
Entity Type:Organization
Organization Name:CITY OF CONWAY SPRINGS
Other - Org Name:CONWAY SPRINGS VOLUNTEER EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CITY CLERK
Authorized Official - Prefix:
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:
Authorized Official - Last Name:WISE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-572-4019
Mailing Address - Street 1:208 W SPRING AVE
Mailing Address - Street 2:
Mailing Address - City:CONWAY SPRINGS
Mailing Address - State:KS
Mailing Address - Zip Code:67031-8288
Mailing Address - Country:US
Mailing Address - Phone:402-572-4019
Mailing Address - Fax:402-965-8594
Practice Address - Street 1:310 WEST SPRING
Practice Address - Street 2:
Practice Address - City:CONWAY SPRINGS
Practice Address - State:KS
Practice Address - Zip Code:67031
Practice Address - Country:US
Practice Address - Phone:402-572-4019
Practice Address - Fax:402-965-8594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-19
Last Update Date:2008-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS4403416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100092130AMedicaid
KS005803OtherBLUE CROSS PROVIDER NO
P00124077OtherRAILROAD MEDICARE PROVIDE
KS100092130AMedicaid