Healthcare Provider Details

I. General information

NPI: 1164693495
Provider Name (Legal Business Name): NAYLOR AMBULANCE ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2008
Last Update Date: 03/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 N FRONT STREET
NAYLOR MO
63953-0056
US

IV. Provider business mailing address

PO BOX 56 101 N. FRONT STREET
NAYLOR MO
63953-0056
US

V. Phone/Fax

Practice location:
  • Phone: 573-399-2727
  • Fax: 573-399-2727
Mailing address:
  • Phone: 573-399-2727
  • Fax: 573-399-2727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number181013
License Number StateMO

VIII. Authorized Official

Name: BRAD J DAVIS
Title or Position: DIRECTOR
Credential: EMT-RN
Phone: 573-399-2727