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Organization

CRYSTAL CITY EMERGENCY SERVICES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
EUGENE DAUCHERT (CEO/PRESIDENT)
(919) 768-4392
Entity
Organization

Contact information

Practice address
HIGHWAY 61 SOUTH, CRYSTAL CITY, MO 63019
(636) 933-1000
(904) 805-1302
Mailing address
PO BOX 827431, PHILADELPHIA, PA 19182-7431
(904) 805-1300
(904) 805-1302

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
363A00000X
Physician Assistant
363L00000X
Nurse Practitioner
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
124884
BLUE CROSS & BLUE SHIELD
MO
01
137529
UMWA
MO
01
426403
HEALTHLINK
MO
Enumeration date
05/04/2006
Last updated
09/11/2025
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