Provider Demographics
NPI:1265702971
Name:CENTRAL CASS COUNTY FIRE & AMBULANCE PROTECTION DISTRICT
Entity type:Organization
Organization Name:CENTRAL CASS COUNTY FIRE & AMBULANCE PROTECTION DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:E
Authorized Official - Last Name:POULIGNOT
Authorized Official - Suffix:III
Authorized Official - Credentials:EMT-P
Authorized Official - Phone:816-380-6744
Mailing Address - Street 1:2507 SE OUTER RD
Mailing Address - Street 2:PO BOX 668
Mailing Address - City:HARRISONVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64701-6366
Mailing Address - Country:US
Mailing Address - Phone:816-380-6744
Mailing Address - Fax:816-884-3366
Practice Address - Street 1:2507 SE OUTER RD
Practice Address - Street 2:
Practice Address - City:HARRISONVILLE
Practice Address - State:MO
Practice Address - Zip Code:64701-6366
Practice Address - Country:US
Practice Address - Phone:816-380-6744
Practice Address - Fax:816-884-3366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-11
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0370793416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport