Provider Demographics
NPI:1295720290
Name:COUNTY OF GRAHAM
Entity type:Organization
Organization Name:COUNTY OF GRAHAM
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EMS FIRE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HELBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-421-3455
Mailing Address - Street 1:722 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HILL CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67642-1936
Mailing Address - Country:US
Mailing Address - Phone:785-421-3455
Mailing Address - Fax:785-421-3473
Practice Address - Street 1:722 W MAIN ST
Practice Address - Street 2:
Practice Address - City:HILL CITY
Practice Address - State:KS
Practice Address - Zip Code:67642-1936
Practice Address - Country:US
Practice Address - Phone:785-421-3455
Practice Address - Fax:785-421-3473
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-15
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS670341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS0005554OtherBLUR CROSS AND BLUE SHIEL
KS100115380BMedicaid
KS100115380BMedicaid