Organization
CITY OF BRENTWOOD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MARCUS HERMAN EMT-CP (ASSISTANT FIRE CHIEF / CMO)
(314) 963-8612
Entity
Organization
Contact information
Practice address
2348 S BRENTWOOD BLVD, BRENTWOOD, MO 63144-2034
(314) 963-8612
(314) 963-3869
Mailing address
PO BOX 798126, SAINT LOUIS, MO 63179-8000
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
189090
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
128050
BCBS PROVIDER NO.
—
01
—
21894
HEALTHCAREUSA PROV. NO.
—
01
—
30341
GHP PROVIDER NO.
—
01
—
389227
HEALTHLINK
—
01
—
590012547
RAILROAD MEDICARE PROV. #
—
05
—
809739006
—
MO
01
—
8181900
UNITED HEALTHCARE PROV NO
—
Enumeration date
11/10/2005
Last updated
02/20/2026
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