Organization
CITY OF RAYTOWN
Active
Organization
CITY OF RAYTOWN
Active
Other names
Raytown Emergency Rescue
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEREMY THOMAS WILLMOTH (DIRECTOR OF FINANCE)
(816) 737-6084
Entity
Organization
Contact information
Practice address
10020 E 66TH TER, RAYTOWN, MO 64133-5251
(816) 737-6030
Mailing address
P.O. BOX 876234, KANSAS CITY, MO 64187-6234
(937) 424-3717
(937) 291-3782
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
095150
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12344017
BLUE CROSS/BLUE SHIELD
MO
01
—
590077790
RAIL ROAD MEDICARE
MO
05
—
800551004
—
MO
Enumeration date
11/09/2006
Last updated
12/01/2010
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