Provider Demographics
NPI:1174318836
Name:KOMAREK, JOSH NICHOLAS (PARAMEDIC)
Entity type:Individual
Prefix:
First Name:JOSH
Middle Name:NICHOLAS
Last Name:KOMAREK
Suffix:
Gender:M
Credentials:PARAMEDIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 N HUMBOLT AVE
Mailing Address - Street 2:
Mailing Address - City:ELLINWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:67526-1542
Mailing Address - Country:US
Mailing Address - Phone:620-566-7513
Mailing Address - Fax:
Practice Address - Street 1:300 N PARK AVE
Practice Address - Street 2:
Practice Address - City:ELLINWOOD
Practice Address - State:KS
Practice Address - Zip Code:67526-1452
Practice Address - Country:US
Practice Address - Phone:620-566-7513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53287146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic