Healthcare Provider Details

I. General information

NPI: 1174651038
Provider Name (Legal Business Name): FORT OSAGE FIRE PROTECTION DIST
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 EAST MONROE
BUCKNER MO
64016-0287
US

IV. Provider business mailing address

PO BOX 747
WHEELING IL
60090-0747
US

V. Phone/Fax

Practice location:
  • Phone: 816-650-5811
  • Fax: 816-650-5819
Mailing address:
  • Phone: 800-244-2345
  • Fax: 800-329-5274

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number095117
License Number StateMO

VIII. Authorized Official

Name: CHRISTINE RUBY
Title or Position: OFFICE MANAGER
Credential:
Phone: 816-650-5811