1407837685 NPI number — THE GOEGGEL COMPANY

Table of content: (NPI 1407837685)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407837685 NPI number — THE GOEGGEL COMPANY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE GOEGGEL COMPANY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
GATEWAY AMBULANCE SERVICE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1407837685
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2888
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAINT LOUIS
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63111-0088
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
314-351-4720
Provider Business Mailing Address Fax Number:
314-351-9935

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
911 HOLLY HILLS AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAINT LOUIS
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63111-2636
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
314-351-4720
Provider Business Practice Location Address Fax Number:
314-351-9935
Provider Enumeration Date:
11/07/2005

Additional Information

Authorized Official

Authorized Official Last Name:
GOEGGEL
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
I
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
314-351-4702

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  189171 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 22691 . This is a "GHP PROVIDER NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0217308 . This is a "CIGNA PROVIDER NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 197518 . This is a "HEALTHLINK PROVIDER NO." identifier . This identifiers is of the category "OTHER".
  • Identifier: 29609 . This is a "BLUE CROSS PROVIDER NO." identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 8100002 . This is a "UHC PROVIDER NUMBER" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 8092 . This is a "HEALTHCAREUSA PROVIDER NO" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".




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