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General NPI Number Information
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NPI Number | 1407192404
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Entity Type | Organization
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Legal Business Name | INTER CITY FIRE PROTECTION DISTRICT
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Dates
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Enumeration Date | 12/19/2012
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Last Update Date | 06/30/2015
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Provider Practice Location Address
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Address Line | 1702 BLUE RIDGE BLVD
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City | BLUE SUMMIT
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State | MO
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Zip | 64126-3016
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Country | US
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Telephone | 816-461-9090
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 641880
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City | OMAHA
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State | NE
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Zip | 68164-7880
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Country | US
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Telephone | 402-572-4019
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Fax | 402-991-0719
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Authorized Official
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Title or Position | CHIEF
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Name | JEFF JEWELL
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Credential |
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Telephone | 816-461-9090
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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 |
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License Number State |
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