Provider Demographics
NPI:1023092764
Name:CITY OF RICHMOND HEIGHTS
Entity type:Organization
Organization Name:CITY OF RICHMOND HEIGHTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:DREXLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-655-3580
Mailing Address - Street 1:PO BOX 795089
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63179-0795
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7447 DALE AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND HEIGHTS
Practice Address - State:MO
Practice Address - Zip Code:63117-2209
Practice Address - Country:US
Practice Address - Phone:314-645-8800
Practice Address - Fax:314-655-3584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-06
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1893243416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00154347OtherRAILROAD MEDICARE PROV. #
MO801653908Medicaid
119462OtherBCBS PROVIDER NO.
8182042OtherUNITED HEALTHCARE PROV #
12573OtherHEALTHCAREUSA PROVIDER #
33671OtherGHP PROVIDER NO.
MO801653908Medicaid