Provider Demographics
NPI:1265400022
Name:COUNTY OF ELLIS
Entity type:Organization
Organization Name:COUNTY OF ELLIS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KERRY
Authorized Official - Middle Name:G
Authorized Official - Last Name:MCCUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-628-9461
Mailing Address - Street 1:1009 CODY AVENUE
Mailing Address - Street 2:
Mailing Address - City:HAYS
Mailing Address - State:KS
Mailing Address - Zip Code:67601
Mailing Address - Country:US
Mailing Address - Phone:785-628-9461
Mailing Address - Fax:785-628-9464
Practice Address - Street 1:1009 CODY AVENUE
Practice Address - Street 2:
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601
Practice Address - Country:US
Practice Address - Phone:785-628-9461
Practice Address - Fax:785-628-9464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-09
Last Update Date:2010-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100113480BMedicaid
KS119990OtherBLUE CROSS BLUE SHIELD
KS663510OtherFIRSTGUARD
KS590009831OtherRAILROAD MEDICARE
KS590009831OtherRAILROAD MEDICARE