Healthcare Provider Details

I. General information

NPI: 1225035413
Provider Name (Legal Business Name): PLEASANT HILL AMBULANCE DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 PINE ST
PLEASANT HILL MO
64080-1658
US

IV. Provider business mailing address

305 PINE ST
PLEASANT HILL MO
64080-1658
US

V. Phone/Fax

Practice location:
  • Phone: 816-540-9108
  • Fax: 816-987-9115
Mailing address:
  • Phone: 816-540-9108
  • Fax: 816-987-9115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number037087
License Number StateMO

VIII. Authorized Official

Name: MR. STEVE LONG
Title or Position: DIRECTOR OF EMS
Credential: EMT-P
Phone: 816-540-9108