Healthcare Provider Details

I. General information

NPI: 1902384993
Provider Name (Legal Business Name): SHOW-ME MEDICAL TRANSPORTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2018
Last Update Date: 08/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31358 AQUA VITA RD
GRAVOIS MILLS MO
65037
US

IV. Provider business mailing address

31358 AQUA VITA RD
GRAVOIS MILLS MO
65037
US

V. Phone/Fax

Practice location:
  • Phone: 573-372-5544
  • Fax: 573-372-5466
Mailing address:
  • Phone: 573-372-5544
  • Fax: 573-372-5466

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: ANGIE SEATON
Title or Position: OWNER / GM
Credential:
Phone: 573-372-5544