Organization
SULLIVAN COUNTY AMBULANCE DISTRICT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATTHEW RYAN KEUHN (ADMINISTRATOR)
(660) 265-3553
Entity
Organization
Contact information
Practice address
113 S LEEWOOD DR, # 1, MILAN, MO 63556-1100
(660) 265-3553
(660) 265-3651
Mailing address
113 S LEEWOOD DR, # 1, MILAN, MO 63556-1100
(660) 265-3553
(660) 265-3651
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
211001
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
800324808
—
MO
Enumeration date
06/21/2005
Last updated
07/13/2011
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