1023146339 NPI number — EUREKA FIRE PROTECTION DISTRICT OF ST. LOUIS COUNTY

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023146339 NPI number — EUREKA FIRE PROTECTION DISTRICT OF ST. LOUIS COUNTY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EUREKA FIRE PROTECTION DISTRICT OF ST. LOUIS COUNTY
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:
Provider Other Organization Name Type Code:
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:
1023146339
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/19/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 796008
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:
63179-6000
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
636-938-5505
Provider Business Mailing Address Fax Number:
636-938-6970

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4849 HIGHWAY 109
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EUREKA
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63025-3737
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
636-938-5505
Provider Business Practice Location Address Fax Number:
636-938-6970
Provider Enumeration Date:
02/28/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BROWN
Authorized Official First Name:
GREGORY
Authorized Official Middle Name:
M
Authorized Official Title or Position:
FIRE CHIEF OF DISTRICT
Authorized Official Telephone Number:
636-935-5505

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  189049 , 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: 590005916 . This is a "MEDICARE - RAILROAD" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 806240305 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 29825 . This is a "BLUE CROSS OF MISSOURI" identifier . This identifiers is of the category "OTHER".




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