Healthcare Provider Details

I. General information

NPI: 1285624445
Provider Name (Legal Business Name): RANDOLPH COUNTY AMBULANCE DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

RR 3 BOX 164AD 1366 E 24 HIGHWAY
MOBERLY MO
65270-9531
US

IV. Provider business mailing address

RR 3 BOX 164AD 1366 E 24 HIGHWAY
MOBERLY MO
65270-9531
US

V. Phone/Fax

Practice location:
  • Phone: 660-263-2267
  • Fax: 660-263-7058
Mailing address:
  • Phone: 660-263-2267
  • Fax: 660-263-7058

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number175005
License Number StateMO

VIII. Authorized Official

Name: MRS. MELODY ARNSPERGER
Title or Position: OFFICE MANAGER
Credential:
Phone: 660-263-2267