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General NPI Number Information
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NPI Number | 1760446660
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Entity Type | Organization
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Legal Business Name | REYNOLDS COUNTY AMBULANCE CENTERVILLE BASE
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Dates
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Enumeration Date | 04/17/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2281 BUFORD ST
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City | CENTERVILLE
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State | MO
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Zip | 63633-0052
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Country | US
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Telephone | 573-648-8009
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Fax | 573-648-2546
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Provider Business Mailing Address
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Address Line | PO BOX 52
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City | CENTERVILLE
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State | MO
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Zip | 63633-0052
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Country | US
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Telephone | 573-648-8009
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Fax | 573-648-2546
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Authorized Official
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Title or Position | CONTRACTOR
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Name | MRS. ANGELA NICHOLE KAEMPFE
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Credential | EMT-B
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Telephone | 573-648-8009
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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 | 179001
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License Number State | MO
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