MEDICARE: NOAH WILLIAM THOMPSON EMT-B, US ARMY 68W

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	146N00000X	Basic Emergency Medical Technician	B-80238	MO

General Provider Information

NPI Number	:	1528928785
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NOAH WILLIAM THOMPSON EMT-B, US ARMY 68W

Provider Business Mailing Address
First Line	:	8 BANBURY CT
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63126-1202
Country	:	US
Telephone Number	:	314-685-7564
Fax Number	:

Provider Business Practice Location Address
First Line	:	28825 US HIGHWAY 61
Second Line	:
City	:	SCOTT CITY
State	:	MO
Zip	:	63780-9137
Country	:	US
Telephone Number	:	573-887-6311
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/12/2025
Last Update Date	:	11/12/2025

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