Provider Demographics
NPI:1407192404
Name:INTER CITY FIRE PROTECTION DISTRICT
Entity Type:Organization
Organization Name:INTER CITY FIRE PROTECTION DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:JEWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-461-9090
Mailing Address - Street 1:PO BOX 641880
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68164-7880
Mailing Address - Country:US
Mailing Address - Phone:402-572-4019
Mailing Address - Fax:402-991-0719
Practice Address - Street 1:1702 BLUE RIDGE BLVD
Practice Address - Street 2:
Practice Address - City:BLUE SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64126-3016
Practice Address - Country:US
Practice Address - Phone:816-461-9090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-19
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1407192404Medicaid
PO1216595OtherRAILROAD MEDICARE
49066011OtherMO BCBS
MA4534Medicare PIN