Healthcare Provider Details

I. General information

NPI: 1073452348
Provider Name (Legal Business Name): MACON COUNTY AMBULANCE DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 N RUTHERFORD ST
MACON MO
63552-5101
US

IV. Provider business mailing address

PO BOX 582
MACON MO
63552-0582
US

V. Phone/Fax

Practice location:
  • Phone: 660-395-8640
  • Fax: 314-317-0193
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CHRIS BOGGUSS
Title or Position: AMBULANCE DIRECTOR
Credential:
Phone: 660-395-8640