1205898574 NPI number — PLANNED PARENTHOOD OF THE ST. LOUIS REGION AND SOUTHWEST MISSOURI

Table of content: (NPI 1205898574)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205898574 NPI number — PLANNED PARENTHOOD OF THE ST. LOUIS REGION AND SOUTHWEST MISSOURI

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PLANNED PARENTHOOD OF THE ST. LOUIS REGION AND SOUTHWEST MISSOURI
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1205898574
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/12/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4251 FOREST PARK AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAINT LOUIS
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63108-2810
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
314-531-7526
Provider Business Mailing Address Fax Number:
314-531-3190

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4251 FOREST PARK AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAINT LOUIS
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63108-2810
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
314-531-7526
Provider Business Practice Location Address Fax Number:
314-531-3190
Provider Enumeration Date:
04/04/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HENDERSON
Authorized Official First Name:
RHONDA
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF ACCOUNTING
Authorized Official Telephone Number:
314-531-7526

Provider Taxonomy Codes

  • Taxonomy code: 332900000X , with the licence number:  2009004523 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QF0050X , with the licence number: 520524208 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 520524224 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 520524232 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 520524240 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 520524257 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 520524208 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 520524216 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".