Organization
TOWN AND COUNTRY AMBULANCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KARLA J GOFF (BILLING CLERK)
(402) 614-7855
Entity
Organization
Contact information
Practice address
110 N 2ND ST, HIAWATHA, KS 66434-2246
(785) 742-3992
(785) 742-7268
Mailing address
PO BOX 456, HIAWATHA, KS 66434-0456
(402) 614-7855
(402) 502-8012
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005632
BC/BS OF KANSAS
—
05
—
100374320A
—
KS
Enumeration date
10/25/2006
Last updated
05/16/2008
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