MEDICARE: COUNTY OF MITCHELL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	341600000X	Ambulance	1320	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023086998
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COUNTY OF MITCHELL

Provider Business Mailing Address
First Line	:	1906 KS 14 HWY
Second Line	:
City	:	BELOIT
State	:	KS
Zip	:	67420-1515
Country	:	US
Telephone Number	:	785-738-6437
Fax Number	:	785-738-4405

Provider Business Practice Location Address
First Line	:	1906 HIGHWAY 14
Second Line	:
City	:	BELOIT
State	:	KS
Zip	:	67420
Country	:	US
Telephone Number	:	785-738-6437
Fax Number	:	785-738-4405

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. EDWARD H DEBESIS
Credential	:	PARAMEDIC
Telephone Number	:	785-738-6437

Provider Enumeration Date	:	03/08/2006
Last Update Date	:	02/12/2013

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Directions to “COUNTY OF MITCHELL ” Practice Location

Language	Start Address	Practice Location

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