Organization
STODDARD COUNTY AMBULANCE DISTRICT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID R COOPER (MANAGER)
(573) 624-4528
Entity
Organization
Contact information
Practice address
501 W BUSINESS US HIGHWAY 60, DEXTER, MO 63841-1027
(573) 624-4528
(573) 624-8648
Mailing address
PO BOX 125, DEXTER, MO 63841-0125
(573) 624-4528
(573) 624-8648
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
207004
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
128744
BLUE CROSS BLUE SHIELD
MO
Enumeration date
01/09/2007
Last updated
08/22/2020
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