Provider Demographics
NPI:1902839095
Name:COLE CAMP COMMUNITY AMBULANCE DISTRICT
Entity Type:Organization
Organization Name:COLE CAMP COMMUNITY AMBULANCE DISTRICT
Other - Org Name:COLE CAMP EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:HARRIS
Authorized Official - Last Name:MEUSCHKE
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:660-687-9077
Mailing Address - Street 1:PO BOX 247
Mailing Address - Street 2:
Mailing Address - City:COLE CAMP
Mailing Address - State:MO
Mailing Address - Zip Code:65325
Mailing Address - Country:US
Mailing Address - Phone:660-668-5006
Mailing Address - Fax:636-989-6929
Practice Address - Street 1:905 E MAIN STREET
Practice Address - Street 2:
Practice Address - City:COLE CAMP
Practice Address - State:MO
Practice Address - Zip Code:65325
Practice Address - Country:US
Practice Address - Phone:660-668-5006
Practice Address - Fax:660-668-3131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2017-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3416L0300X
MO0150323416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
9006445Medicare PIN
MO9006445Medicare PIN