Healthcare Provider Details

I. General information

NPI: 1629034814
Provider Name (Legal Business Name): CITY OF JUNCTION CITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 11/07/2022
Certification Date: 11/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 N JEFFERSON ST
JUNCTION CITY KS
66441-2979
US

IV. Provider business mailing address

700 N JEFFERSON ST P O BOX 287
JUNCTION CITY KS
66441-3598
US

V. Phone/Fax

Practice location:
  • Phone: 785-238-6822
  • Fax: 785-762-3684
Mailing address:
  • Phone: 785-238-6822
  • Fax: 785-762-3684

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code146L00000X
TaxonomyParamedic
License Number910
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code146M00000X
TaxonomyIntermediate Emergency Medical Technician
License Number910
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number910
License Number StateKS
# 4
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: TERRY JOHNSON
Title or Position: FIRE/EMS CHIEF
Credential:
Phone: 785-238-6822