Provider Demographics
NPI:1598843450
Name:SOUTH METROPOLITAN FIRE PROTECTION DISTRICT
Entity Type:Organization
Organization Name:SOUTH METROPOLITAN FIRE PROTECTION DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF/DISTRICT MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:LEE
Authorized Official - Middle Name:R
Authorized Official - Last Name:STEVENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-331-3008
Mailing Address - Street 1:PO BOX 467
Mailing Address - Street 2:
Mailing Address - City:RAYMORE
Mailing Address - State:MO
Mailing Address - Zip Code:64083-0467
Mailing Address - Country:US
Mailing Address - Phone:816-331-3008
Mailing Address - Fax:844-704-9561
Practice Address - Street 1:611 W FOXWOOD DR
Practice Address - Street 2:
Practice Address - City:RAYMORE
Practice Address - State:MO
Practice Address - Zip Code:64083-9194
Practice Address - Country:US
Practice Address - Phone:816-331-3008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2018-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO037061341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO590005873OtherRAIL ROAD MEDICARE
MO801658402Medicaid
KS100276100AOtherKS MEDICAID
MO08814015OtherBLUE CROSS/BLUE SHIELD
MO08814015OtherBLUE CROSS/BLUE SHIELD