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General NPI Number Information
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NPI Number | 1720169303
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Entity Type | Organization
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Legal Business Name | FLORISSANT VALLEY FIRE PRO DIST
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 04/18/2024
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Provider Practice Location Address
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Address Line | 605 SAINT CATHERINE ST
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City | FLORISSANT
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State | MO
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Zip | 63031-4946
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Country | US
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Telephone | 800-538-8278
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Fax | 580-628-2273
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Provider Business Mailing Address
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Address Line | 605 SAINT CATHERINE ST
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City | FLORISSANT
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State | MO
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Zip | 63031-4946
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Country | US
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Telephone | 800-538-8278
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Fax | 580-628-2273
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Authorized Official
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Title or Position | CHIEF MEDICAL OFFICER
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Name | MARK FLAUTER
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Credential |
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Telephone | 800-538-8278
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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 | 189472
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License Number State | MO
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