Provider Demographics
NPI:1265415111
Name:CITY OF WEBSTER GROVES
Entity type:Organization
Organization Name:CITY OF WEBSTER GROVES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:CAPRIGLIONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-963-5328
Mailing Address - Street 1:6 S ELM AVE
Mailing Address - Street 2:
Mailing Address - City:WEBSTER GROVES
Mailing Address - State:MO
Mailing Address - Zip Code:63119-3016
Mailing Address - Country:US
Mailing Address - Phone:314-963-5328
Mailing Address - Fax:314-962-4504
Practice Address - Street 1:6 S ELM AVE
Practice Address - Street 2:
Practice Address - City:WEBSTER GROVES
Practice Address - State:MO
Practice Address - Zip Code:63119-3016
Practice Address - Country:US
Practice Address - Phone:314-963-5328
Practice Address - Fax:314-962-4504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-23
Last Update Date:2009-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1893753416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
826590274OtherRAILROAD MEDICARE
15668OtherGROUP HEALTH PLAN
29746OtherBLUE CROSS BLUE SHIELD
MO808718803Medicaid
81-81264OtherUNITED HEALTHCARE
81-81264OtherUNITED HEALTHCARE