Healthcare Provider Details

I. General information

NPI: 1033026968
Provider Name (Legal Business Name): ST. FRANCOIS COUNTY AMBULANCE DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

624 WALLACE RD
FARMINGTON MO
63640-9217
US

IV. Provider business mailing address

624 WALLACE RD
FARMINGTON MO
63640-9217
US

V. Phone/Fax

Practice location:
  • Phone: 573-756-6764
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code146E00000X
TaxonomyCommunity Paramedic
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: KRISTY RENA HALTER
Title or Position: OFFICE MANAGER
Credential:
Phone: 573-431-0030