Organization
JEFFERSON COUNTY FIRE DIST # 11
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN ELDON GORDON EMT-I (SERVICE DIRECTOR)
(785) 945-3731
Entity
Organization
Contact information
Practice address
204 LOUISA ST, VALLEY FALLS, KS 66088-1331
(785) 945-3731
(785) 945-3456
Mailing address
PO BOX 66, VALLEY FALLS, KS 66088-0066
(785) 945-3731
(785) 945-3456
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
605
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
112032
BLUE CROSS BLUE SHIELD
KS
05
—
200002750A
—
KS
01
—
P00041600000X
RAILROAD MEDICARE
—
01
—
P00041979
RAILROAD MEDICARE
KS
Enumeration date
08/31/2006
Last updated
11/21/2013
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