# JEFFERSON COUNTY FIRE DIST \# 11

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710098934
- **Authorized official:** MR. JOHN ELDON GORDON EMT-I (SERVICE DIRECTOR)
- **Authorized official phone:** (785) 945-3731

## Contact information

- **Practice address:** 204 LOUISA ST, VALLEY FALLS, KS 66088-1331
- **Practice address phone:** (785) 945-3731
- **Practice address fax:** (785) 945-3456
- **Mailing address:** PO BOX 66, VALLEY FALLS, KS 66088-0066
- **Mailing address phone:** (785) 945-3731
- **Mailing address fax:** (785) 945-3456

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 341600000X | Ambulance | 605 | KS | Yes |

## Other

- **Enumeration date:** 08/31/2006
- **Last updated:** 11/21/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 112032 | BLUE CROSS BLUE SHIELD | KS |
| 05 | — | 200002750A | — | KS |
| 01 | — | P00041600000X | RAILROAD MEDICARE | — |
| 01 | — | P00041979 | RAILROAD MEDICARE | KS |