Provider Demographics
NPI:1447781703
Name:FIRST TOUCH SOCCER EQUIPMENT LLC
Entity Type:Organization
Organization Name:FIRST TOUCH SOCCER EQUIPMENT LLC
Other - Org Name:CALIBER CARE & TRANSPORT OF ST. LOUIS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER / PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:P
Authorized Official - Last Name:NEWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-433-3313
Mailing Address - Street 1:14830 LONG BRANCH CT
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-5409
Mailing Address - Country:US
Mailing Address - Phone:314-433-3313
Mailing Address - Fax:
Practice Address - Street 1:14830 LONG BRANCH CT
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-5409
Practice Address - Country:US
Practice Address - Phone:314-433-3313
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-27
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)