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General NPI Number Information
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NPI Number | 1558340877
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Entity Type | Organization
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Legal Business Name | CLARK COUNTY AMBULANCE DISTRICT
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Dates
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Enumeration Date | 01/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 211 N VINE ST
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City | KAHOKA
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State | MO
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Zip | 63445-1283
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Country | US
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Telephone | 660-727-3612
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Fax | 660-727-2182
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Provider Business Mailing Address
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Address Line | 211 N VINE ST
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City | KAHOKA
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State | MO
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Zip | 63445-1283
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Country | US
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Telephone | 660-727-3612
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Fax | 660-727-2182
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. CINDA I JAMES
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Credential |
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Telephone | 660-727-3612
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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 | 045004
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License Number State | MO
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