Healthcare Provider Details
I. General information
NPI: 1578556023
Provider Name (Legal Business Name): MIDWEST EMERGENCY MEDICAL SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/30/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2800 CLAY EDWARDS DR
NORTH KANSAS CITY MO
64116-3220
US
IV. Provider business mailing address
PO BOX 11157
KANSAS CITY MO
64119-0157
US
V. Phone/Fax
- Phone: 816-346-7220
- Fax: 816-346-7242
- Phone: 855-381-3941
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | |
| License Number State | MO |
VIII. Authorized Official
Name: DR.
STEVEN
L
RUSSELL
Title or Position: PRESIDENT
Credential: MD
Phone: 816-346-7220