Iron County Ambulance District
Organization Active NPI Land Ambulance · Pilot Knob, MO
NPI 1497932107 · NPPES record last updated Jan 24, 2008
Key facts
- NPI
- 1497932107
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- License
- 093017 (MO)
- Legal business name
- IRON COUNTY AMBULANCE DISTRICT
- Practice address
- 115 South McCune Street
Pilot Knob, MO 63663 - Phone
- (573) 546-3951
- Fax
- (573) 244-5959
- NPI assigned
- Jan 24, 2008
- Organization subpart
- No
Authorized official
- Name
- Mr. Kevin Queen
- Title
- President
- Phone
- (573) 546-3951
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 26D1068577 | Iron County Ambulance District | Certificate of waiver | May 15, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080211000611 | MO | Part B Supplier - Ambulance Service Supplier | 6204919467 | Practice locations: Pilot Knob, MO |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 093017 | MO | Yes |
Addresses
Primary practice location
115 South McCune Street
Pilot Knob, MO 63663
Mailing address
PO Box 366
Ironton, MO 63650-0366
Phone (573) 546-3951
Other providers in Pilot Knob, MO
- Boonyasai & Boonyasai, M.D.P. C.
- Boonfu Boonyasai
- Vatana C. Boonyasai
- Harry Taylor Harness
- Jami Hedrick
- Iron County Hospital District
- Iron County Hospital District
- Chelsea L Isgrig
- James Mathis, M.D.
- Cindy Kaye Larkin
All providers in Pilot Knob, MO · Land Ambulance in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 24, 2008. 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.