Organization
COUNTY OF HARPER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE LOREG MICT (DIRECTOR)
(620) 842-3506
Entity
Organization
Contact information
Practice address
123 N JENNINGS AVE, ANTHONY, KS 67003-2708
(620) 842-3506
(620) 842-3309
Mailing address
123 N JENNINGS AVE, PO BOX 251, ANTHONY, KS 67003-2708
(620) 842-3506
(620) 842-3309
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
9-01316
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
019028
BLUE CROSS
KS
05
—
100243560-A
—
KS
01
—
590007680
RAILROAD MEDICARE
KS
Enumeration date
05/10/2006
Last updated
06/28/2010
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