Organization
PRAIRIE BAND POTAWATOMI NATION
Active
Organization
PRAIRIE BAND POTAWATOMI NATION
Active
Other names
Potawatomi Tribal Fire Department
Organization subpart
No
Provider details
NPI number
Authorized official
LIANA ONNEN (TRIBAL CHAIRPERSON)
(785) 966-4007
Entity
Organization
Contact information
Practice address
15468 K RD, MAYETTA, KS 66509-9093
(785) 966-2164
Mailing address
15482 K RD, MAYETTA, KS 66509-9093
(785) 966-2164
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
1555
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100416330A
—
KS
01
—
112020
BLUE CROSS/BLUE SHIELD
KS
Enumeration date
05/19/2006
Last updated
07/20/2017
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