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General NPI Number Information
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NPI Number | 1457327850
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Entity Type | Organization
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Legal Business Name | PATTONVILLE FIRE PROTECTION DISTRICT
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Dates
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Enumeration Date | 02/24/2006
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Last Update Date | 04/16/2008
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Provider Practice Location Address
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Address Line | 13900 SAINT CHARLES ROCK RD
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City | BRIDGETON
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State | MO
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Zip | 63044-3826
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Country | US
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Telephone | 314-739-3118
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 66711
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City | SAINT LOUIS
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State | MO
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Zip | 63166-6711
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ASSISTANT CHIEF
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Name | MATT LAVANCHY
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Credential |
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Telephone | 314-739-3118
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 189405
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License Number State | MO
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