1871577411 NPI number — WEST OVERLAND FIRE PROTECTION DIST OF ST LOUIS COUNTY

Table of content: (NPI 1871577411)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871577411 NPI number — WEST OVERLAND FIRE PROTECTION DIST OF ST LOUIS COUNTY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WEST OVERLAND FIRE PROTECTION DIST 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:
1871577411
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/01/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 501157
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:
63150-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10789 MIDLAND BLVD
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:
63114-1839
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
314-428-6069
Provider Business Practice Location Address Fax Number:
314-428-3114
Provider Enumeration Date:
12/06/2005

Additional Information

Authorized Official

Authorized Official Last Name:
MARLO
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF
Authorized Official Telephone Number:
314-428-6069

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  189189 , 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: 33608 . This is a "GHP PROVIDER NO." identifier . This identifiers is of the category "OTHER".
  • Identifier: 8181099 . This is a "UNITED HEALTHCARE PROV #" identifier . This identifiers is of the category "OTHER".
  • Identifier: 590012870 . This is a "RAILROAD MEDICARE PROV #" identifier . This identifiers is of the category "OTHER".
  • Identifier: 119728 . This is a "BCBS PROVIDER NO." identifier . This identifiers is of the category "OTHER".
  • Identifier: 9019 . This is a "HEALTHCAREUSA PROVIDER NO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 801179805 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com