Organization
PATTONVILLE FIRE PROTECTION DISTRICT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATT LAVANCHY (ASSISTANT CHIEF)
(314) 739-3118
Entity
Organization
Contact information
Practice address
13900 SAINT CHARLES ROCK RD, BRIDGETON, MO 63044-3826
(314) 739-3118
Mailing address
PO BOX 66711, SAINT LOUIS, MO 63166-6711
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
189405
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
106051
HEALTHLINK PROVIDER #
—
01
—
11740
HEALTHCAREUSA PROVIDER #
MO
01
—
29843
BLUE CROSS BLUE SHIELD
—
01
—
32822
GHP PROVIDER NUMBER
—
01
—
8180045
UHC PROVIDER #
—
01
—
P00220288
RR MEDICARE PROVIDER #
—
Enumeration date
02/24/2006
Last updated
04/16/2008
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