Provider Demographics
NPI:1477215382
Name:CITY OF KENNETT
Entity Type:Organization
Organization Name:CITY OF KENNETT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SAFETY OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:TYLER
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-344-7843
Mailing Address - Street 1:200 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:KENNETT
Mailing Address - State:MO
Mailing Address - Zip Code:63857-2002
Mailing Address - Country:US
Mailing Address - Phone:573-344-7843
Mailing Address - Fax:
Practice Address - Street 1:309 SAINT FRANCIS ST
Practice Address - Street 2:
Practice Address - City:KENNETT
Practice Address - State:MO
Practice Address - Zip Code:63857-1960
Practice Address - Country:US
Practice Address - Phone:573-888-5337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-07
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance