MEDICARE: CITY OF OSAGE BEACH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	341600000X	Ambulance	029025	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	29837	OTHER	MO	BLUE CROSS BLUE SHIELD OF
4	431033564AMB	OTHER	MO	MERCY HEALTH PLAN

General Provider Information

NPI Number	:	1306813514
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY OF OSAGE BEACH

Provider Business Mailing Address
First Line	:	1000 CITY PKWY
Second Line	:
City	:	OSAGE BEACH
State	:	MO
Zip	:	65065-3058
Country	:	US
Telephone Number	:	573-302-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 CITY PKWY
Second Line	:
City	:	OSAGE BEACH
State	:	MO
Zip	:	65065-3058
Country	:	US
Telephone Number	:	573-302-2000
Fax Number	:

Authorized Official
Title or Position	:	FINANCIAL ADVISOR
Name	:	MRS. KARRI L BELL
Credential	:
Telephone Number	:	573-302-2000

Provider Enumeration Date	:	03/07/2006
Last Update Date	:	02/03/2009

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Directions to “CITY OF OSAGE BEACH ” Practice Location

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