Healthcare Provider Details

I. General information

NPI: 1477481265
Provider Name (Legal Business Name): NORTH CALLAWAY FIRE PROTECTION DIST
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5144 OLD US HIGHWAY 40
KINGDOM CITY MO
65262-2033
US

IV. Provider business mailing address

PO BOX 62
KINGDOM CITY MO
65262-0062
US

V. Phone/Fax

Practice location:
  • Phone: 573-642-9339
  • Fax:
Mailing address:
  • Phone: 573-642-9339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW WALTON
Title or Position: FIRE CHIEF
Credential:
Phone: 314-761-7792