Provider Demographics
NPI:1952490682
Name:CITY OF ST LOUIS
Entity Type:Organization
Organization Name:CITY OF ST LOUIS
Other - Org Name:CITY OF ST LOUIS FIRE DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:M
Authorized Official - Last Name:JENKERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-533-3406
Mailing Address - Street 1:PO BOX 956134
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63195-6135
Mailing Address - Country:US
Mailing Address - Phone:314-645-5639
Mailing Address - Fax:314-645-4566
Practice Address - Street 1:2634 HAMPTON AVENUE
Practice Address - Street 2:CITY OF ST LOUIS EMERGENCY MEDICAL SERVICES
Practice Address - City:ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63139-2913
Practice Address - Country:US
Practice Address - Phone:314-646-7108
Practice Address - Fax:314-645-4556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO800626608Medicaid
000006422Medicare ID - Type Unspecified