Provider Demographics
NPI:1003814328
Name:ADAIR COUNTY AMBULANCE DISTRICT
Entity type:Organization
Organization Name:ADAIR COUNTY AMBULANCE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PATIENT BILLING
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:PROBST
Authorized Official - Suffix:
Authorized Official - Credentials:PARAMEDIC
Authorized Official - Phone:660-665-0000
Mailing Address - Street 1:606 W POTTER AVE
Mailing Address - Street 2:
Mailing Address - City:KIRKSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63501-1168
Mailing Address - Country:US
Mailing Address - Phone:660-665-0000
Mailing Address - Fax:660-665-2775
Practice Address - Street 1:606 W POTTER AVE
Practice Address - Street 2:
Practice Address - City:KIRKSVILLE
Practice Address - State:MO
Practice Address - Zip Code:63501-1168
Practice Address - Country:US
Practice Address - Phone:660-665-0000
Practice Address - Fax:660-665-2775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-11
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0010153416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO29673OtherBLUE CROSS BLUE SHIELD
MO802215301Medicaid
MO29673OtherBLUE CROSS BLUE SHIELD
MO802215301Medicaid