Provider Demographics
NPI:1770621542
Name:DIXON AMBULANCE DISTRICT
Entity type:Organization
Organization Name:DIXON AMBULANCE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:DRISCOLL
Authorized Official - Suffix:
Authorized Official - Credentials:EMTP
Authorized Official - Phone:573-759-7447
Mailing Address - Street 1:PO BOX 396
Mailing Address - Street 2:
Mailing Address - City:DIXON
Mailing Address - State:MO
Mailing Address - Zip Code:65459-0396
Mailing Address - Country:US
Mailing Address - Phone:573-759-7447
Mailing Address - Fax:573-759-7098
Practice Address - Street 1:305 S. ELLEN ST.
Practice Address - Street 2:
Practice Address - City:DIXON
Practice Address - State:MO
Practice Address - Zip Code:65459
Practice Address - Country:US
Practice Address - Phone:573-759-7447
Practice Address - Fax:573-759-7098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1690213416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport