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General NPI Number Information
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NPI Number | 1700855392
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Entity Type | Organization
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Legal Business Name | CITY OF DES PERES
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Dates
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Enumeration Date | 03/16/2006
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Last Update Date | 02/14/2023
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Provider Practice Location Address
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Address Line | 1000 N BALLAS RD
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City | DES PERES
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State | MO
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Zip | 63131-3706
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Country | US
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Telephone | 314-822-1500
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Fax |
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Provider Business Mailing Address
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Address Line | 12325 MANCHESTER RD
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City | SAINT LOUIS
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State | MO
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Zip | 63131-4316
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Country | US
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Telephone | 314-835-6113
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Fax |
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Authorized Official
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Title or Position | ASSISTANT FIRE CHIEF
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Name | DALE FIALA
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Credential |
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Telephone | 314-835-6231
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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 | 189201
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License Number State | MO
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