Healthcare Provider Details

I. General information

NPI: 1174670483
Provider Name (Legal Business Name): NORTH CRAWFORD CO AMBULANCE DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2007
Last Update Date: 03/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 AMERICAN WAY
CUBA MO
65453-7339
US

IV. Provider business mailing address

PO BOX 523
CUBA MO
65453-0523
US

V. Phone/Fax

Practice location:
  • Phone: 573-885-3793
  • Fax: 573-885-2077
Mailing address:
  • Phone: 573-885-3793
  • Fax: 573-885-2077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State

VIII. Authorized Official

Name: MR. GREGORY PAUL CAMPBELL
Title or Position: ADMINISTRATOR
Credential:
Phone: 573-885-3793