Provider Demographics
NPI:1306321880
Name:CITY OF CHILLICOTHE
Entity type:Organization
Organization Name:CITY OF CHILLICOTHE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:BETTE
Authorized Official - Middle Name:J
Authorized Official - Last Name:ATWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:660-646-4355
Mailing Address - Street 1:700 2ND ST
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:MO
Mailing Address - Zip Code:64601-2555
Mailing Address - Country:US
Mailing Address - Phone:660-646-4355
Mailing Address - Fax:660-707-0434
Practice Address - Street 1:700 2ND ST
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:MO
Practice Address - Zip Code:64601-2555
Practice Address - Country:US
Practice Address - Phone:660-646-4355
Practice Address - Fax:660-707-0434
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CITY OF CHILLICOTHE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-10-01
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO11263011OtherBCBS
NE800546608Medicaid