Organization
SNI VALLEY FIRE PROTECTION DISTRICT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MIKE JOHNSON (ASSISTANT CHIEF)
(816) 690-6990
Entity
Organization
Contact information
Practice address
1601 S BROADWAY ST, OAK GROVE, MO 64075-9023
(816) 690-6990
(816) 690-6191
Mailing address
PO BOX 55, WATSONTOWN, PA 17777-0055
(570) 538-4488
(570) 538-1556
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
095265
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00882
RAIL ROAD MEDICARE
MO
01
—
20657011
BLUE CROSS
MO
Enumeration date
01/29/2007
Last updated
08/22/2020
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