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General NPI Number Information
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NPI Number | 1225048754
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Entity Type | Organization
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Legal Business Name | ST. FRANCOIS COUNTY AMBULANCE DISTRICT
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 02/24/2012
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Provider Practice Location Address
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Address Line | 820 ELECTRIC ST
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City | FARMINGTON
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State | MO
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Zip | 63640-9215
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Country | US
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Telephone | 573-756-6764
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Fax | 576-431-7014
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Provider Business Mailing Address
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Address Line | 624 WALLACE RD
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City | FARMINGTON
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State | MO
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Zip | 63640-9217
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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 | OFFICE MANAGER
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Name | HEATHER MERRITT
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Credential |
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Telephone | 573-756-6764
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 187011
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License Number State | MO
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