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General NPI Number Information
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NPI Number | 1700962149
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Entity Type | Organization
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Legal Business Name | OTIS EMS
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Dates
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Enumeration Date | 10/27/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | LAURA & MAIN ST
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City | OTIS
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State | KS
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Zip | 67565
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Country | US
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Telephone | 785-387-2296
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 155
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City | OTIS
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State | KS
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Zip | 67565-0155
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Country | US
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Telephone | 785-387-2296
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Fax | 785-387-2323
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Authorized Official
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Title or Position | BILLING DIRECTOR
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Name | EVERETT ROYER
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Credential | EMT-I
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Telephone | 785-387-2296
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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 | 1480
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License Number State | KS
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