Healthcare Provider Details

I. General information

NPI: 1700989092
Provider Name (Legal Business Name): COUNTY OF MORTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2006
Last Update Date: 08/31/2020
Certification Date: 08/31/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

722 STEVENS AVENUE
ELKHART KS
67950
US

IV. Provider business mailing address

PO BOX 863
ELKHART KS
67950-0863
US

V. Phone/Fax

Practice location:
  • Phone: 620-697-4251
  • Fax: 620-697-4261
Mailing address:
  • Phone: 620-697-4251
  • Fax: 620-697-4261

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number1340
License Number StateKS

VIII. Authorized Official

Name: DUSTY BRILLHART
Title or Position: SUPERVISOR
Credential: DIRECTOR
Phone: 620-697-4251