Organization
CITY OF DES PERES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DALE FIALA (ASSISTANT FIRE CHIEF)
(314) 835-6231
Entity
Organization
Contact information
Practice address
1000 N BALLAS RD, DES PERES, MO 63131-3706
(314) 822-1500
Mailing address
12325 MANCHESTER RD, SAINT LOUIS, MO 63131-4316
(314) 835-6113
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
189201
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
127801
BLUE CROSS PROVIDER NO.
—
01
—
19819
HEALTHCAREUSA PROVIDER #
MO
01
—
29933
GHP PROVIDER NO.
—
05
—
805146701
—
MO
01
—
8181789
UNITED HEALTHCARE PROV. #
—
01
—
P00140402
RAILROAD MEDICARE PROV. #
—
Enumeration date
03/16/2006
Last updated
02/14/2023
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