MEDICARE: BARRY-LAWRENCE COUNTY AMBULANCE DISTRICT

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	3416L0300X	Land Ambulance	009041	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

General Provider Information

NPI Number	:	1861492563
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BARRY-LAWRENCE COUNTY AMBULANCE DISTRICT

Provider Business Mailing Address
First Line	:	PO BOX 384
Second Line	:	307 DAIRY STREET
City	:	MONETT
State	:	MO
Zip	:	65708-0384
Country	:	US
Telephone Number	:	417-235-3102
Fax Number	:

Provider Business Practice Location Address
First Line	:	307 DAIRY ST
Second Line	:
City	:	MONETT
State	:	MO
Zip	:	65708-2520
Country	:	US
Telephone Number	:	417-235-3102
Fax Number	:

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	PAULA FLORY
Credential	:
Telephone Number	:	417-235-3102

Provider Enumeration Date	:	07/26/2005
Last Update Date	:	05/21/2024

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