Organization
DEKALB CLINTON AMBULANCE DISTRICT NO 1
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ROSE L BARNES (SUPERVISOR)
(816) 669-3642
Entity
Organization
Contact information
Practice address
261 SE OFFUTT RD, PO 501, MAYSVILLE, MO 64469-9149
(816) 669-3642
(816) 669-3642
Mailing address
261 SE OFFUTT RD, PO BOX 501, MAYSVILLE, MO 64469-9149
(816) 669-3642
(816) 669-3642
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
063002
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08167011
BLUE CROSS BLUE SHIELD
MO
01
—
590077838A
RAILROAD MEDICARE
MO
01
—
T02666154
VA CHAMPUS
MO
Enumeration date
06/30/2005
Last updated
12/02/2016
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