=====================================================
General NPI Number Information
=====================================================
NPI Number | 1013933308
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CITY OF HARRISONVILLE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/14/2006
-----------------------------------------------------
Last Update Date | 11/09/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 903 S COMMERCIAL ST
-----------------------------------------------------
City | HARRISONVILLE
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64701-1655
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 816-380-8923
-----------------------------------------------------
Fax | 816-380-5630
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 903 S COMMERCIAL ST
-----------------------------------------------------
City | HARRISONVILLE
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64701-1655
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 816-380-8923
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EMS DIRECTOR
-----------------------------------------------------
Name | LARRY FRANCES
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 816-380-8925
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3416L0300X
-----------------------------------------------------
Taxonomy Name | Land Ambulance
-----------------------------------------------------
License Number | 037001
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------