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Organization

ST. JAMES AMBULANCE DISTRICT

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. BRYAN T LAMBETH (ADMINISTRATOR)
(573) 265-6565
Entity
Organization

Contact information

Practice address
203 S. LOUISE, ST. JAMES, MO 65559
(573) 265-6565
(573) 265-0342
Mailing address
203 S. LOUISE, ST. JAMES, MO 65559
(573) 265-6565
(573) 265-0342

Taxonomy

Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
161012
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
590014355
RR MEDICARE PROVIDER
MO
05
800548901
MO
Enumeration date
08/30/2006
Last updated
05/16/2012
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