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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