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General NPI Number Information
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NPI Number | 1285718254
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Entity Type | Organization
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Legal Business Name | TOWN AND COUNTRY AMBULANCE LLC
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 05/16/2008
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Provider Practice Location Address
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Address Line | 110 N 2ND ST
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City | HIAWATHA
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State | KS
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Zip | 66434-2246
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Country | US
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Telephone | 785-742-3992
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Fax | 785-742-7268
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Provider Business Mailing Address
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Address Line | PO BOX 456
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City | HIAWATHA
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State | KS
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Zip | 66434-0456
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Country | US
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Telephone | 402-614-7855
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Fax | 402-502-8012
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Authorized Official
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Title or Position | BILLING CLERK
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Name | KARLA J GOFF
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Credential |
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Telephone | 402-614-7855
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number |
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License Number State |
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