Organization
SEDGWICK COUNTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TASHA HARRIS (DIRECTOR)
(531) 895-5853
Entity
Organization
Contact information
Practice address
315 CEDAR ST, JULESBURG, CO 80737-1532
(970) 474-3313
(970) 474-9885
Mailing address
10802 FARNAM DR, OMAHA, NE 68154-3237
(877) 218-4392
(877) 343-0131
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
—
CO
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06638035
—
CO
01
—
35919
BLUE CROSS BLUE SHIELD
CO
01
—
590042202
PALMETTO GBA
CO
01
—
846000801
TRICARE
CO
Enumeration date
12/27/2005
Last updated
06/20/2025
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