Village of Creve Coeur

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

000002528 Issued in IL

Legal business name

VILLAGE OF CREVE COEUR

Practice address

203 Wagner Drive
Creve Coeur, IL 61610

Phone

(309) 682-5280

Fax

(309) 682-5327

NPI assigned

Feb 9, 2007

Last updated

Aug 15, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Brad Gill

Title

Fire Chief

Phone

(309) 303-6519

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Creve Coeur Fire Department Other name

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218758400000",
    "number": "1043351414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 N THORNCREST AVE",
            "city": "CREVE COEUR",
            "state": "IL",
            "postal_code": "61610",
            "telephone_number": "309-682-5280",
            "fax_number": "309-682-5327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 WAGNER DRIVE",
            "city": "CREVE COEUR",
            "state": "IL",
            "postal_code": "61610",
            "telephone_number": "309-682-5280",
            "fax_number": "309-682-5327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE OF CREVE COEUR",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2008-08-15",
        "status": "A",
        "authorized_official_last_name": "GILL",
        "authorized_official_first_name": "BRAD",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "309-303-6519",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IL",
            "license": "000002528",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALLMETTO GBA",
            "identifier": "5900065841",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "09032043",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Creve Coeur Fire Department",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Land Ambulance in Creve Coeur, IL
• Providers in Creve Coeur, IL by specialty
• Land Ambulance in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.