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Organization
COUNTY OF LEAVENWORTH
Active
Organization
COUNTY OF LEAVENWORTH
Active
Other names
Leavenworth County EMS
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMIE A MILLER MICT (DIRECTOR)
(913) 250-8000
Entity
Organization
Contact information
Practice address
500 EISENHOWER RD STE 103, LEAVENWORTH, KS 66048-5161
(913) 250-8000
(913) 250-0063
Mailing address
500 EISENHOWER RD STE 103, LEAVENWORTH, KS 66048-5161
(913) 250-8000
(913) 250-0063
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
1010
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
035970
FIRST GAURD MEDICAID HMO
MO
05
—
100091480C
—
KS
05
—
10523977
—
NY
01
—
144275700
KANSAS DEPT OF LABOR
—
05
—
200085760A
—
OK
01
—
20842016
BCBS OF KANSAS CITY
—
01
—
291732
CAPITOL BCBS
—
01
—
590077899
RAILROAD MEDICARE PGBA
—
05
—
800465007
—
MO
Enumeration date
09/07/2006
Last updated
08/09/2011
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