Provider Demographics
NPI:1700962149
Name:OTIS EMS
Entity type:Organization
Organization Name:OTIS EMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:EVERETT
Authorized Official - Middle Name:
Authorized Official - Last Name:ROYER
Authorized Official - Suffix:
Authorized Official - Credentials:EMT-I
Authorized Official - Phone:785-387-2296
Mailing Address - Street 1:PO BOX 155
Mailing Address - Street 2:
Mailing Address - City:OTIS
Mailing Address - State:KS
Mailing Address - Zip Code:67565-0155
Mailing Address - Country:US
Mailing Address - Phone:785-387-2296
Mailing Address - Fax:785-387-2323
Practice Address - Street 1:LAURA & MAIN ST
Practice Address - Street 2:
Practice Address - City:OTIS
Practice Address - State:KS
Practice Address - Zip Code:67565
Practice Address - Country:US
Practice Address - Phone:785-387-2296
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14803416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport