Organization
CARROLL COUNTY AMBULANCE DISTRICT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHERI CLAVIN EMTP (ADMINISTRATOR)
(660) 542-1808
Entity
Organization
Contact information
Practice address
603 N MASON ST, CARROLLTON, MO 64633-2252
(660) 542-1808
(660) 542-1072
Mailing address
603 N MASON ST, P.O. BOX 511, CARROLLTON, MO 64633-2252
(660) 542-1808
(660) 542-1072
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
033014
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03576019
BLUE CROSS BLUE SHIELD
MO
01
—
100472
EDI
MO
01
—
10K4112
BCBS OF MO
MO
Enumeration date
08/26/2005
Last updated
08/22/2020
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