Organization
FLORISSANT VALLEY FIRE PRO DIST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK FLAUTER (CHIEF MEDICAL OFFICER)
(800) 538-8278
Entity
Organization
Contact information
Practice address
605 SAINT CATHERINE ST, FLORISSANT, MO 63031-4946
(800) 538-8278
(580) 628-2273
Mailing address
605 SAINT CATHERINE ST, FLORISSANT, MO 63031-4946
(800) 538-8278
(580) 628-2273
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
189472
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
129152
BCBS PROVIDER NUMBER
MO
01
—
590014098
RRMC PROVIDER NUMBER
MO
05
—
805125903
—
MO
Enumeration date
10/18/2006
Last updated
04/18/2024
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