Provider Demographics
NPI:1770531519
Name:CITY OF HIGGINSVILLE
Entity type:Organization
Organization Name:CITY OF HIGGINSVILLE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EMS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:W
Authorized Official - Last Name:KENNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:660-584-2106
Mailing Address - Street 1:PO BOX 781621
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67278-1621
Mailing Address - Country:US
Mailing Address - Phone:855-626-9660
Mailing Address - Fax:833-953-0588
Practice Address - Street 1:211 W 19TH ST
Practice Address - Street 2:
Practice Address - City:HIGGINSVILLE
Practice Address - State:MO
Practice Address - Zip Code:64037-1510
Practice Address - Country:US
Practice Address - Phone:660-584-6780
Practice Address - Fax:660-584-3663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-04
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1070183416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO124351OtherHEALTHLINK
MO03431012OtherBLUE CROSS BLUE SHIELD
MO590077713OtherRAILROAD MEDICARE
MO008990OtherFAMILY HEALTH PARTNERS
MO800549016Medicaid
MO306130OtherFIRST GUARD
TN4020637OtherBCBS OF TENNESSEE
MO800549016Medicaid