Healthcare Provider Details

I. General information

NPI: 1154373173
Provider Name (Legal Business Name): COUNTY OF GREENWOOD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 11/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 S JEFFERSON ST
EUREKA KS
67045-2205
US

IV. Provider business mailing address

PO BOX 51
EUREKA KS
67045-0051
US

V. Phone/Fax

Practice location:
  • Phone: 316-689-3551
  • Fax: 316-689-3556
Mailing address:
  • Phone: 316-689-3551
  • Fax: 316-689-3556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number730
License Number StateKS

VIII. Authorized Official

Name: DIANNA PADGETT
Title or Position: BILLING MANAGER
Credential:
Phone: 316-689-3551