Provider Demographics
NPI:1528167475
Name:COUNTY OF REPUBLIC
Entity type:Organization
Organization Name:COUNTY OF REPUBLIC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT DIRECTOR/BILLING CLERK
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:MULLIS-HAVEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-527-7149
Mailing Address - Street 1:2405 F STREET
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:KS
Mailing Address - Zip Code:66935-2434
Mailing Address - Country:US
Mailing Address - Phone:785-527-7149
Mailing Address - Fax:785-527-5638
Practice Address - Street 1:2405 F STREET
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:KS
Practice Address - Zip Code:66935-2434
Practice Address - Country:US
Practice Address - Phone:785-527-7149
Practice Address - Fax:785-527-5638
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS16203416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS005836OtherBLUE CROSS BLUE SHIELD
KS100089410CMedicaid
KS590077732OtherRAILROAD MEDICARE