Healthcare Provider Details

I. General information

NPI: 1770531519
Provider Name (Legal Business Name): CITY OF HIGGINSVILLE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 04/14/2022
Certification Date: 04/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 W 19TH ST
HIGGINSVILLE MO
64037-1510
US

IV. Provider business mailing address

PO BOX 781621
WICHITA KS
67278-1621
US

V. Phone/Fax

Practice location:
  • Phone: 660-584-6780
  • Fax: 660-584-3663
Mailing address:
  • Phone: 855-626-9660
  • Fax: 833-953-0588

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number107018
License Number StateMO

VIII. Authorized Official

Name: DOUGLAS W KENNEY
Title or Position: EMS DIRECTOR
Credential:
Phone: 660-584-2106