Ray County Ambulance District
Organization Active NPI Land Ambulance · Richmond, MO
NPI 1013961259 · NPPES record last updated Dec 20, 2011
Key facts
- NPI
- 1013961259
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- License
- 17708 (MO)
- Legal business name
- RAY COUNTY AMBULANCE DISTRICT
- Practice address
- 208 Wollard Blvd
Richmond, MO 64085-1928 - Phone
- (816) 470-3030
- NPI assigned
- May 20, 2006
- Organization subpart
- No
Authorized official
- Name
- Sammy Moppin
- Title
- EMS Coordinator
- Phone
- (816) 470-3030
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 26D0963716 | Ray County Ambulance District | Certificate of waiver | Aug 5, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120221000116 | MO | Part B Supplier - Ambulance Service Supplier | 3274791330 | Practice locations: Richmond, MO |
National Provider Directory
Locations
208 Wollard Blvd
Richmond, MO 64085
Phone (816) 470-3030
10625 Lee Holt Ln
Richmond, MO 64085
Phone (816) 470-3030
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 17708 | MO | Yes |
Addresses
Primary practice location
208 Wollard Blvd
Richmond, MO 64085-1928
Mailing address
PO Box 514
Richmond, MO 64085-0514
Phone (816) 470-3030
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 802049908 | Medicaid | MO | |
| 11428016 | Other | MO | BLUE CROSS |
Other providers in Richmond, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 20, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.