Provider Demographics
NPI:1033190525
Name:FENTON FIRE PROTECTION DISTRICT
Entity type:Organization
Organization Name:FENTON FIRE PROTECTION DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:636-343-4188
Mailing Address - Street 1:845 GREGORY LN
Mailing Address - Street 2:
Mailing Address - City:FENTON
Mailing Address - State:MO
Mailing Address - Zip Code:63026-3110
Mailing Address - Country:US
Mailing Address - Phone:636-343-4188
Mailing Address - Fax:636-343-4451
Practice Address - Street 1:845 GREGORY LN
Practice Address - Street 2:
Practice Address - City:FENTON
Practice Address - State:MO
Practice Address - Zip Code:63026-3110
Practice Address - Country:US
Practice Address - Phone:636-343-4188
Practice Address - Fax:636-343-4451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1894303416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
12510OtherHEALTHCAREUSA PROV NO.
329961OtherHEALTHLINK PROVIDER NO.
590014622OtherRAILROAD MEDICARE PROV #
889159OtherCOMMUNITY CARE PROV #
125199OtherBCBS PROVIDER NO.
53498OtherGHP PROVIDER NO.
8100019OtherUNITED HEALTHCARE PROV. #
MO808538003Medicaid