MEDICARE: JOHNSON COUNTY FIRE DISTRICT NO 2 RURAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance	1805	KS

General Provider Information

NPI Number	:	1386698157
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHNSON COUNTY FIRE DISTRICT NO 2 RURAL

Provider Business Mailing Address
First Line	:	19495 METCALF AVE
Second Line	:
City	:	STILWELL
State	:	KS
Zip	:	66085-8524
Country	:	US
Telephone Number	:	913-681-2764
Fax Number	:	913-681-2786

Provider Business Practice Location Address
First Line	:	19495 METCALF AVE
Second Line	:
City	:	STILWELL
State	:	KS
Zip	:	66085-8524
Country	:	US
Telephone Number	:	913-681-2764
Fax Number	:	913-681-2786

Authorized Official
Title or Position	:	FIRE CHIEF
Name	:	STEVE CHICK
Credential	:
Telephone Number	:	913-681-2764

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	08/06/2014

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