Provider Demographics
NPI:1972505758
Name:CITY OF WASHINGTON
Entity Type:Organization
Organization Name:CITY OF WASHINGTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROLINE
Authorized Official - Middle Name:A
Authorized Official - Last Name:SCOVILLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-325-2284
Mailing Address - Street 1:PO BOX 296
Mailing Address - Street 2:301 C STREET
Mailing Address - City:WASHINGTON
Mailing Address - State:KS
Mailing Address - Zip Code:66968-0296
Mailing Address - Country:US
Mailing Address - Phone:785-325-2284
Mailing Address - Fax:785-325-2678
Practice Address - Street 1:900 D ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:KS
Practice Address - Zip Code:66968-2402
Practice Address - Country:US
Practice Address - Phone:785-325-2284
Practice Address - Fax:785-325-2678
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-11
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2040341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS826590031OtherRAILROAD MEDICARE ID
KS005518OtherBLUE CROSS BLUE SHIELD KS
KS100091490AMedicaid
KS180833OtherUCARE OF MINNESOTA ID
NE=========00Medicaid
KS180833OtherUCARE OF MINNESOTA ID