Healthcare Provider Details

I. General information

NPI: 1407992225
Provider Name (Legal Business Name): SNI VALLEY FIRE PROTECTION DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 S BROADWAY ST
OAK GROVE MO
64075-9023
US

IV. Provider business mailing address

PO BOX 55
WATSONTOWN PA
17777-0055
US

V. Phone/Fax

Practice location:
  • Phone: 816-690-6990
  • Fax: 816-690-6191
Mailing address:
  • Phone: 570-538-4488
  • Fax: 570-538-1556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number095265
License Number StateMO

VIII. Authorized Official

Name: MR. MIKE JOHNSON
Title or Position: ASSISTANT CHIEF
Credential:
Phone: 816-690-6990