Provider Demographics
NPI:1982786356
Name:CITY OF STOCKTON
Entity Type:Organization
Organization Name:CITY OF STOCKTON
Other - Org Name:ROOKS COUNTY EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-425-6703
Mailing Address - Street 1:115 S WALNUT ST
Mailing Address - Street 2:P.O. BOX 512
Mailing Address - City:STOCKTON
Mailing Address - State:KS
Mailing Address - Zip Code:67669-1985
Mailing Address - Country:US
Mailing Address - Phone:785-425-6703
Mailing Address - Fax:785-425-6424
Practice Address - Street 1:115 S WALNUT ST
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:KS
Practice Address - Zip Code:67669-1985
Practice Address - Country:US
Practice Address - Phone:785-425-6863
Practice Address - Fax:785-425-6424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2018-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1890341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100091620AMedicaid
KS005566Medicare ID - Type Unspecified