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General NPI Number Information
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NPI Number | 1699757997
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Entity Type | Organization
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Legal Business Name | ROBERTSON FIRE PROTECTION DISTRICT
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Dates
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Enumeration Date | 11/14/2005
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Last Update Date | 04/16/2008
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Provider Practice Location Address
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Address Line | 12641 MISSOURI BOTTOM RD
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City | HAZELWOOD
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State | MO
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Zip | 63042-1517
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Country | US
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Telephone | 314-291-6180
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 771242
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City | SAINT LOUIS
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State | MO
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Zip | 63177-2242
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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 | FIRE CHIEF
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Name | DAVID TILLEY
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Credential |
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Telephone | 314-291-6671
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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 | 189359
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License Number State | MO
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