Provider Demographics
NPI:1215075411
Name:COUNTY OF SEDGWICK
Entity type:Organization
Organization Name:COUNTY OF SEDGWICK
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EMS DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:R
Authorized Official - Last Name:HADLEY
Authorized Official - Suffix:
Authorized Official - Credentials:EMT-P, BSN, RN
Authorized Official - Phone:316-660-7994
Mailing Address - Street 1:1015 W STILLWELL ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67213-4450
Mailing Address - Country:US
Mailing Address - Phone:316-660-7994
Mailing Address - Fax:316-383-7338
Practice Address - Street 1:1015 W STILLWELL ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67213-4450
Practice Address - Country:US
Practice Address - Phone:316-660-7994
Practice Address - Fax:316-383-7338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17503416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100080500FMedicaid
KS005650OtherBLUE CROSS BLUE SHIELD
KS826590746OtherRAILROAD MEDICARE
KS005650Medicare PIN