Provider Demographics
NPI:1336217645
Name:WEST PECULIAR FIRE PROTECTION DISTRICT
Entity type:Organization
Organization Name:WEST PECULIAR FIRE PROTECTION DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT FIRE CHIEF / EMS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:LOAR
Authorized Official - Suffix:III
Authorized Official - Credentials:EMT-P
Authorized Official - Phone:816-779-5766
Mailing Address - Street 1:200 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PECULIAR
Mailing Address - State:MO
Mailing Address - Zip Code:64078-9612
Mailing Address - Country:US
Mailing Address - Phone:816-779-5766
Mailing Address - Fax:816-779-5769
Practice Address - Street 1:200 S MAIN ST
Practice Address - Street 2:
Practice Address - City:PECULIAR
Practice Address - State:MO
Practice Address - Zip Code:64078-9612
Practice Address - Country:US
Practice Address - Phone:816-779-5766
Practice Address - Fax:816-779-5769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0371093416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO25456018OtherBLUE CROSS
MO590015120OtherRAIL ROAD MEDICARE
MO803978709Medicaid