Organization
CHEROKEE COUNTY AMBULANCE ASSOC. DIST. III
Active
Organization
CHEROKEE COUNTY AMBULANCE ASSOC. DIST. III
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RONALD JAMES COSTLOW PARAMEDIC (SERVICE DIRECTOR)
(620) 856-2561
Entity
Organization
Contact information
Practice address
311 MILITARY AVENUE, BAXTER SPRINGS, KS 66713-0137
(620) 856-2561
(620) 856-3585
Mailing address
P.O. BOX 137, BAXTER SPRINGS, KS 66713-0137
(620) 856-2561
(620) 856-3585
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
300
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005547
BLUE CROSS/BLUE SHIELD #
KS
05
—
100091570A
—
KS
05
—
100817370A
—
OK
01
—
590006034
RAILROAD MEDICARE
KS
05
—
801647603
—
MO
Enumeration date
10/03/2006
Last updated
03/11/2013
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