Healthcare Provider Details

I. General information

NPI: 1588663892
Provider Name (Legal Business Name): COUNTY OF RICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 07/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1488 HIGHWAY 56
LYONS KS
67554-9209
US

IV. Provider business mailing address

1488 HIGHWAY 56 PO BOX 505
LYONS KS
67554-0505
US

V. Phone/Fax

Practice location:
  • Phone: 620-257-5200
  • Fax: 620-257-7851
Mailing address:
  • Phone: 620-257-5200
  • Fax: 620-257-7851

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number1640
License Number StateKS

VIII. Authorized Official

Name: MR. TERRY DAVID
Title or Position: DIRECTOR
Credential:
Phone: 620-257-5200