=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376845008
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | REGIONAL EMERGENCY MEDICAL SERVICES AUTHORITY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/01/2010
-----------------------------------------------------
Last Update Date | 08/16/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5010 FREDERICK AVE
-----------------------------------------------------
City | SAINT JOSEPH
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64506-3248
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 816-396-9580
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 843774
-----------------------------------------------------
City | KANSAS CITY
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64184
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 855-626-9660
-----------------------------------------------------
Fax | 833-953-0588
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | WALLACE N. PATRICK
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 816-396-9580
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3416L0300X
-----------------------------------------------------
Taxonomy Name | Land Ambulance
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------