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General NPI Number Information
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NPI Number | 1477550937
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Entity Type | Organization
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Legal Business Name | DEKALB CLINTON AMBULANCE DISTRICT NO 1
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Dates
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Enumeration Date | 06/30/2005
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Last Update Date | 12/02/2016
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Provider Practice Location Address
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Address Line | 261 SE OFFUTT RD PO 501
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City | MAYSVILLE
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State | MO
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Zip | 64469-9149
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Country | US
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Telephone | 816-669-3642
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Fax | 816-669-3642
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Provider Business Mailing Address
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Address Line | 261 SE OFFUTT RD PO BOX 501
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City | MAYSVILLE
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State | MO
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Zip | 64469-9149
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Country | US
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Telephone | 816-669-3642
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Fax | 816-669-3642
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Authorized Official
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Title or Position | SUPERVISOR
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Name | MRS. ROSE L BARNES
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Credential |
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Telephone | 816-669-3642
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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 | 063002
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License Number State | MO
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