Barry-Lawrence County Ambulance District
Organization Active NPI Land Ambulance · Monett, MO
NPI 1861492563 · NPPES record last updated May 21, 2024
Key facts
- NPI
- 1861492563
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- License
- 009041 (MO)
- Legal business name
- BARRY-LAWRENCE COUNTY AMBULANCE DISTRICT
- Practice address
- 307 Dairy St
Monett, MO 65708-2520 - Phone
- (417) 235-3102
- NPI assigned
- Jul 26, 2005
- Organization subpart
- No
Authorized official
- Name
- Paula Flory
- Title
- Office Manager
- Phone
- (417) 235-3102
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 26D1023065 | Barry-Lawrence County Ambulance District | Certificate of waiver | Mar 7, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050531000077 | MO | Part B Supplier - Ambulance Service Supplier | 9234171398 | Practice locations: Monett, MO |
National Provider Directory
Locations
307 Dairy St
Monett, MO 65708
Phone (417) 235-3102
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 009041 | MO | Yes |
Addresses
Primary practice location
307 Dairy St
Monett, MO 65708-2520
Mailing address
PO Box 384
307 Dairy Street
Monett, MO 65708-0384
Phone (417) 235-3102
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 800628505 | Medicaid | MO |
Other providers in Monett, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 21, 2024. 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.