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General NPI Number Information
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NPI Number | 1871577411
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Entity Type | Organization
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Legal Business Name | WEST OVERLAND FIRE PROTECTION DIST OF ST LOUIS COUNTY
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Dates
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Enumeration Date | 12/06/2005
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Last Update Date | 05/01/2013
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Provider Practice Location Address
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Address Line | 10789 MIDLAND BLVD
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City | SAINT LOUIS
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State | MO
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Zip | 63114-1839
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Country | US
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Telephone | 314-428-6069
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Fax | 314-428-3114
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Provider Business Mailing Address
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Address Line | PO BOX 501157
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City | SAINT LOUIS
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State | MO
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Zip | 63150-0001
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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 | CHIEF
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Name | MICHAEL MARLO
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Credential |
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Telephone | 314-428-6069
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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 | 189189
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License Number State | MO
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