MEDICARE: CITY OF WEBSTER GROVES

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	189375	MO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	826590274	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
2	15668	OTHER	GROUP HEALTH PLAN
3	29746	OTHER	BLUE CROSS BLUE SHIELD
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	81-81264	OTHER	UNITED HEALTHCARE

General Provider Information

NPI Number	:	1265415111
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY OF WEBSTER GROVES

Provider Business Mailing Address
First Line	:	6 S ELM AVE
Second Line	:
City	:	WEBSTER GROVES
State	:	MO
Zip	:	63119-3016
Country	:	US
Telephone Number	:	314-963-5328
Fax Number	:	314-962-4504

Provider Business Practice Location Address
First Line	:	6 S ELM AVE
Second Line	:
City	:	WEBSTER GROVES
State	:	MO
Zip	:	63119-3016
Country	:	US
Telephone Number	:	314-963-5328
Fax Number	:	314-962-4504

Authorized Official
Title or Position	:	FIRE CHIEF
Name	:	MR. MICHAEL J. CAPRIGLIONE
Credential	:
Telephone Number	:	314-963-5328

Provider Enumeration Date	:	11/23/2005
Last Update Date	:	02/02/2009

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Directions to “CITY OF WEBSTER GROVES ” Practice Location

Language	Start Address	Practice Location

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