Organization
COUNTY OF CRAWFORD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RANDY SANDBERG MICT (DIRECTOR EMS)
(620) 231-3344
Entity
Organization
Contact information
Practice address
270 N INDUSTRIAL DR, FRONTENAC, KS 66763
(620) 231-3344
Mailing address
P.O.BOX 292, GIRARD, KS 66743
(620) 231-3344
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
460
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005563
BLUE CROSS/BLUE SHIELD
KS
05
—
100091610D
—
KS
01
—
665310
FIRST GUARD
KS
05
—
800626707
—
MO
01
—
826590053
R.R. MEDICARE
KS
Enumeration date
10/03/2006
Last updated
12/15/2015
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