MEDICARE: WEST PECULIAR FIRE PROTECTION DISTRICT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance	037109	MO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	590015120	OTHER	MO	RAIL ROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	25456018	OTHER	MO	BLUE CROSS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336217645
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEST PECULIAR FIRE PROTECTION DISTRICT

Provider Business Mailing Address
First Line	:	200 S MAIN ST
Second Line	:
City	:	PECULIAR
State	:	MO
Zip	:	64078-9612
Country	:	US
Telephone Number	:	816-779-5766
Fax Number	:	816-779-5769

Provider Business Practice Location Address
First Line	:	200 S MAIN ST
Second Line	:
City	:	PECULIAR
State	:	MO
Zip	:	64078-9612
Country	:	US
Telephone Number	:	816-779-5766
Fax Number	:	816-779-5769

Authorized Official
Title or Position	:	ASSISTANT FIRE CHIEF / EMS MANAGER
Name	:	RALPH LOUIS LOAR III
Credential	:	EMT-P
Telephone Number	:	816-779-5766

Provider Enumeration Date	:	12/04/2006
Last Update Date	:	12/15/2022

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Directions to “WEST PECULIAR FIRE PROTECTION DISTRICT ” Practice Location

Language	Start Address	Practice Location

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