Provider Demographics
NPI:1285734236
Name:COUNTY OF CLARK
Entity type:Organization
Organization Name:COUNTY OF CLARK
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:RAMONA
Authorized Official - Middle Name:J
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-635-2832
Mailing Address - Street 1:PO BOX 886
Mailing Address - Street 2:913 HIGHLAND
Mailing Address - City:ASHLAND
Mailing Address - State:KS
Mailing Address - Zip Code:67831-0886
Mailing Address - Country:US
Mailing Address - Phone:620-635-2832
Mailing Address - Fax:620-635-2992
Practice Address - Street 1:913 HIGHLAND STREET
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KS
Practice Address - Zip Code:67831-0886
Practice Address - Country:US
Practice Address - Phone:620-635-2832
Practice Address - Fax:620-635-2992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS3403416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100243860AMedicaid
KS019098Medicare ID - Type Unspecified