=====================================================
General NPI Number Information
=====================================================
NPI Number | 1588702849
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | COUNTY OF FINNEY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/01/2007
-----------------------------------------------------
Last Update Date | 04/28/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 803 W MARY ST
-----------------------------------------------------
City | GARDEN CITY
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 67846-2747
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 620-272-3822
-----------------------------------------------------
Fax | 620-272-3830
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 311 N 9TH ST BOX M
-----------------------------------------------------
City | GARDEN CITY
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 67846-5312
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 620-272-3530
-----------------------------------------------------
Fax | 620-272-3582
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SERVICE DIRECTOR
-----------------------------------------------------
Name | MR. SKYLAR WILLIAM SWORDS
-----------------------------------------------------
Credential | PARAMEDIC
-----------------------------------------------------
Telephone | 620-272-3822
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3416L0300X
-----------------------------------------------------
Taxonomy Name | Land Ambulance
-----------------------------------------------------
License Number | KS023
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------