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Organization

COUNTY OF STAFFORD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. CLAYTON E. GRIMMETT (SF CO COMMISSION CHAIRMAN)
(620) 549-3509
Entity
Organization

Contact information

Practice address
636 E. 4TH, ST. JOHN, KS 67576
(620) 549-3765
Mailing address
636 E. 4TH, ST. JOHN, KS 67576
(620) 549-3765

Taxonomy

Speciality
Code
Description
License number
State
341600000X
Ambulance
3416L0300X
Land Ambulance
Primary
1855
KS

Other

Enumeration date
06/13/2005
Last updated
09/16/2009
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