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General NPI Number Information
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NPI Number | 1265702971
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Entity Type | Organization
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Legal Business Name | CENTRAL CASS COUNTY FIRE & AMBULANCE PROTECTION DISTRICT
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Dates
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Enumeration Date | 01/11/2012
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Last Update Date | 01/11/2012
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Provider Practice Location Address
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Address Line | 2507 SE OUTER RD
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City | HARRISONVILLE
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State | MO
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Zip | 64701-6366
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Country | US
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Telephone | 816-380-6744
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Fax | 816-884-3366
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Provider Business Mailing Address
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Address Line | 2507 SE OUTER RD PO BOX 668
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City | HARRISONVILLE
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State | MO
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Zip | 64701-6366
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Country | US
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Telephone | 816-380-6744
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Fax | 816-884-3366
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Authorized Official
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Title or Position | ASSISTANT CHIEF
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Name | MR. GEORGE E POULIGNOT III
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Credential | EMT-P
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Telephone | 816-380-6744
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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 | 037079
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License Number State | MO
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