Healthcare Provider Details

I. General information

NPI: 1952486201
Provider Name (Legal Business Name): CITY OF UNIVERSITY CITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 06/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6801 DELMAR BLVD
UNIVERSITY CITY MO
63130-3104
US

IV. Provider business mailing address

6801 DELMAR BLVD
UNIVERSITY CITY MO
63130-3104
US

V. Phone/Fax

Practice location:
  • Phone: 800-538-8278
  • Fax: 580-628-2273
Mailing address:
  • Phone: 800-538-8278
  • Fax: 580-628-2273

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number189197
License Number StateMO

VIII. Authorized Official

Name: GARY WILMOTH
Title or Position: FIRE CHIEF
Credential:
Phone: 314-505-8594