Provider Demographics
NPI:1720087976
Name:COUNTY OF OSBORNE
Entity Type:Organization
Organization Name:COUNTY OF OSBORNE
Other - Org Name:OSBORNE COUNTY EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:BOLAND
Authorized Official - Suffix:
Authorized Official - Credentials:EMT/TOII
Authorized Official - Phone:785-346-2379
Mailing Address - Street 1:117 N 1ST ST
Mailing Address - Street 2:
Mailing Address - City:OSBORNE
Mailing Address - State:KS
Mailing Address - Zip Code:67473-2001
Mailing Address - Country:US
Mailing Address - Phone:785-346-2379
Mailing Address - Fax:785-345-4031
Practice Address - Street 1:117 N 1ST ST
Practice Address - Street 2:
Practice Address - City:OSBORNE
Practice Address - State:KS
Practice Address - Zip Code:67473-2001
Practice Address - Country:US
Practice Address - Phone:785-346-2379
Practice Address - Fax:785-345-4031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-19
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1470146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, BasicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100091710BMedicaid
KS100091710BMedicaid