Healthcare Provider Details

I. General information

NPI: 1679402044
Provider Name (Legal Business Name): IMPERIUM TRANSPORTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3316 RUSSELL BLVD APT 1
SAINT LOUIS MO
63104-1561
US

IV. Provider business mailing address

3316 RUSSELL BLVD APT 1
SAINT LOUIS MO
63104-1561
US

V. Phone/Fax

Practice location:
  • Phone: 314-307-8097
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MS. DANA MOORE
Title or Position: OWNER
Credential:
Phone: 314-307-8097