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General NPI Number Information
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NPI Number | 1144628611
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Entity Type | Organization
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Legal Business Name | EMS OF CHILLICOTHE LLC
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Dates
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Enumeration Date | 12/15/2014
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Last Update Date | 08/25/2019
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Provider Practice Location Address
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Address Line | 2799 N WASHINGTON ST
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City | CHILLICOTHEE
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State | MO
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Zip | 64601-2902
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Country | US
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Telephone | 469-401-2386
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 99088
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City | LAS VEGAS
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State | NV
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Zip | 89193-9085
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OFFICER
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Name | GREGORY J BYRNE
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Credential | MD
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Telephone | 954-838-2371
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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