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General NPI Number Information
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NPI Number | 1760630032
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Entity Type | Organization
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Legal Business Name | MADISON COUNTY AMBULANCE DISTRICT
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Dates
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Enumeration Date | 08/28/2008
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Last Update Date | 04/12/2021
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Provider Practice Location Address
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Address Line | 126 RIVER BLUFF DR
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City | FREDERICKTOWN
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State | MO
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Zip | 63645-6364
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Country | US
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Telephone | 573-783-7900
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Fax | 573-783-5456
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Provider Business Mailing Address
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Address Line | PO BOX 492
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City | FREDERICKTOWN
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State | MO
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Zip | 63645-0492
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Country | US
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Telephone | 573-783-2552
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | PEGGY MCKIM
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Credential |
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Telephone | 573-783-7900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | PENDING
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License Number State | MO
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