Scotland County Ambulance District
Organization Active NPI Land Ambulance · Memphis, MO
NPI 1043780158 · NPPES record last updated May 31, 2019
Key facts
- NPI
- 1043780158
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- Legal business name
- SCOTLAND COUNTY AMBULANCE DISTRICT
- Practice address
- 435 E Grand Ave
Memphis, MO 63555-1501 - Phone
- (660) 465-2111
- NPI assigned
- Dec 1, 2018
- Organization subpart
- No
Authorized official
- Name
- Erick Byrn
- Title
- EMS Director
- Phone
- (660) 465-2111
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 26D2090630 | Scotland County Ambulance District | Certificate of waiver | Jan 26, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190719000869 | MO | Part B Supplier - Ambulance Service Supplier | 3274869896 | Practice locations: Memphis, MO |
National Provider Directory
Locations
435 E Grand Ave
Memphis, MO 63555
Phone (660) 465-2111
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | Yes |
Addresses
Primary practice location
435 E Grand Ave
Memphis, MO 63555-1501
Mailing address
435 E Grand Ave
Memphis, MO 63555-1501
Phone (660) 465-2111
Other providers in Memphis, MO
- Pkanesthesia, Inc
- Kenneth Bruce Quenneville
- Lois Quenneville
- Nicholas R Rhodes
- Scotland Co. R-1
- Scotland County Community Health Development Services, Inc.
- Scotland County Health Department & Home Health Agency
- Scotland County Health Department & Home Health Agency
- Scotland County Memorial Hospital
- Scotland County Memorial Hospital
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 31, 2019. 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.