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General NPI Number Information
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NPI Number | 1770561151
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Entity Type | Organization
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Legal Business Name | MARQUETTE AMBULANCE SERVICE
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Dates
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Enumeration Date | 01/05/2006
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Last Update Date | 06/08/2008
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Provider Practice Location Address
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Address Line | 111 S WASHINGTON
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City | MARQUETTE
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State | KS
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Zip | 67464-0026
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Country | US
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Telephone | 785-546-2424
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Fax | 785-546-2424
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Provider Business Mailing Address
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Address Line | PO BOX 26
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City | MARQUETTE
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State | KS
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Zip | 67464-0026
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Country | US
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Telephone | 785-546-2424
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Fax | 785-546-2424
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Authorized Official
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Title or Position | DIRECTOR
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Name | MAX DOUGLAS BUFFINGTON
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Credential | EMT
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Telephone | 785-546-2506
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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 | 1170
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License Number State | KS
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