Provider Demographics
NPI:1366646630
Name:OSAGE AMBULANCE DISTRICT
Entity type:Organization
Organization Name:OSAGE AMBULANCE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DISTRICT ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:KRULL
Authorized Official - Suffix:
Authorized Official - Credentials:CCEMT-P, NREMT-P
Authorized Official - Phone:573-897-0044
Mailing Address - Street 1:P.O. BOX 557
Mailing Address - Street 2:
Mailing Address - City:LINN
Mailing Address - State:MO
Mailing Address - Zip Code:65051-0557
Mailing Address - Country:US
Mailing Address - Phone:573-897-0044
Mailing Address - Fax:573-897-0787
Practice Address - Street 1:119 HIGHWAY 89 SOUTH
Practice Address - Street 2:
Practice Address - City:LINN
Practice Address - State:MO
Practice Address - Zip Code:65051-0557
Practice Address - Country:US
Practice Address - Phone:573-897-0044
Practice Address - Fax:573-897-0787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO000006991Medicare Oscar/Certification