Healthcare Provider Details

I. General information

NPI: 1699760686
Provider Name (Legal Business Name): COUNTY OF THOMAS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2005
Last Update Date: 11/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1275 S FRANKLIN AVE
COLBY KS
67701-3718
US

IV. Provider business mailing address

1275 S FRANKLIN AVE
COLBY KS
67701-3718
US

V. Phone/Fax

Practice location:
  • Phone: 785-460-4585
  • Fax: 785-460-4586
Mailing address:
  • Phone: 785-460-4585
  • Fax: 785-460-4586

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number1950
License Number StateKS

VIII. Authorized Official

Name: MR. NORMAN JOSEPH HICKERT II
Title or Position: DIRECTOR
Credential: RN, NREMT-P
Phone: 785-460-4585