Provider Demographics
NPI:1730274143
Name:COUNTY OF CRAWFORD
Entity type:Organization
Organization Name:COUNTY OF CRAWFORD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR EMS
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MICT
Authorized Official - Phone:620-231-3344
Mailing Address - Street 1:P.O.BOX 292
Mailing Address - Street 2:
Mailing Address - City:GIRARD
Mailing Address - State:KS
Mailing Address - Zip Code:66743
Mailing Address - Country:US
Mailing Address - Phone:620-231-3344
Mailing Address - Fax:
Practice Address - Street 1:270 N INDUSTRIAL DR
Practice Address - Street 2:
Practice Address - City:FRONTENAC
Practice Address - State:KS
Practice Address - Zip Code:66763
Practice Address - Country:US
Practice Address - Phone:620-231-3344
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2015-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS4603416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO800626707Medicaid
KS826590053OtherR.R. MEDICARE
KS665310OtherFIRST GUARD
KS005563OtherBLUE CROSS/BLUE SHIELD
KS100091610DMedicaid
KS826590053OtherR.R. MEDICARE