MEDICARE: CITY OF RICHMOND HEIGHTS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance	189324	MO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00154347	OTHER		RAILROAD MEDICARE PROV. #

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	8182042	OTHER	UNITED HEALTHCARE PROV #
3	33671	OTHER	GHP PROVIDER NO.
4	119462	OTHER	BCBS PROVIDER NO.
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	12573	OTHER	HEALTHCAREUSA PROVIDER #

General Provider Information

NPI Number	:	1023092764
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY OF RICHMOND HEIGHTS

Provider Business Mailing Address
First Line	:	1330 S BIG BEND BLVD
Second Line	:
City	:	RICHMOND HEIGHTS
State	:	MO
Zip	:	63117-2202
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7447 DALE AVE
Second Line	:
City	:	RICHMOND HEIGHTS
State	:	MO
Zip	:	63117-2209
Country	:	US
Telephone Number	:	314-645-8800
Fax Number	:	314-655-3584

Authorized Official
Title or Position	:	BATTALION CHIEF & MEDICAL OFFICER
Name	:	LEO A DAVIS
Credential	:
Telephone Number	:	314-645-8800

Provider Enumeration Date	:	12/06/2005
Last Update Date	:	07/31/2025

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Directions to “CITY OF RICHMOND HEIGHTS ” Practice Location

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