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Organization

WEST OVERLAND FIRE PROTECTION DIST OF ST LOUIS COUNTY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL MARLO (CHIEF)
(314) 428-6069
Entity
Organization

Contact information

Practice address
10789 MIDLAND BLVD, SAINT LOUIS, MO 63114-1839
(314) 428-6069
(314) 428-3114
Mailing address
PO BOX 501157, SAINT LOUIS, MO 63150-0001

Taxonomy

Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
189189
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
119728
BCBS PROVIDER NO.
01
33608
GHP PROVIDER NO.
01
590012870
RAILROAD MEDICARE PROV #
05
801179805
MO
01
8181099
UNITED HEALTHCARE PROV #
01
9019
HEALTHCAREUSA PROVIDER NO
Enumeration date
12/06/2005
Last updated
05/01/2013
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