Stoddard County Ambulance District

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

207004 Issued in MO

Legal business name

STODDARD COUNTY AMBULANCE DISTRICT

Practice address

501 W Business US Highway 60
Dexter, MO 63841-1027

Phone

(573) 624-4528

Fax

(573) 624-8648

NPI assigned

Jan 9, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. David R Cooper

Title

Manager

Phone

(573) 624-4528

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114076296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 125",
            "city": "DEXTER",
            "state": "MO",
            "postal_code": "638410125",
            "telephone_number": "573-624-4528",
            "fax_number": "573-624-8648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 W BUSINESS US HIGHWAY 60",
            "city": "DEXTER",
            "state": "MO",
            "postal_code": "638411027",
            "telephone_number": "573-624-4528",
            "fax_number": "573-624-8648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STODDARD COUNTY AMBULANCE DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "573-624-4528",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "MO",
            "license": "207004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Specialty Products & Services, Inc (Quail Run Group Home)
• Specialty Products & Services, Inc.
• John Loren Starwalt, DO
• Phillip Wesley Stegman, PHARMD
• Stoddard Co Arc
• Stoddard County Arc GH
• Stoddard County Arc GH 2W
• Stoddard County Arc Isl
• Stoddard County Family Care LLC
• Stoddard County Targeted Case Management Inc

• Land Ambulance in Dexter, MO
• Providers in Dexter, MO by specialty
• Land Ambulance in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.