Organization
CITY OF HAZELWOOD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JIM MATHIES (FIRE CHIEF)
(800) 538-8278
Entity
Organization
Contact information
Practice address
6800 HOWDERSHELL RD, HAZELWOOD, MO 63042-1214
(800) 538-8278
(580) 628-2273
Mailing address
6800 HOWDERSHELL RD, HAZELWOOD, MO 63042-1214
(800) 538-8278
(580) 628-2273
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
189235
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000013441
ESSENCE PROVIDER NUMBER
MO
01
—
198286
BCBS PROVIDER NUMBER
MO
05
—
806216206
—
MO
Enumeration date
10/18/2006
Last updated
02/26/2013
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