1780639088 NPI number — COUNTY OF ST LOUIS DIVISION OF FISCAL MANAGEMENT

Table of content: (NPI 1780639088)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780639088 NPI number — COUNTY OF ST LOUIS DIVISION OF FISCAL MANAGEMENT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNTY OF ST LOUIS DIVISION OF FISCAL MANAGEMENT
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:
ST LOUIS COUNTY DEPT OF HEALTH
Provider Other Organization Name Type Code:
3
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:
1780639088
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/17/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6121 N HANLEY RD
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:
63134-2003
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
314-615-0500
Provider Business Mailing Address Fax Number:
314-615-8303

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6121 N HANLEY RD
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:
63134-2003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
314-615-0600
Provider Business Practice Location Address Fax Number:
314-615-8303
Provider Enumeration Date:
05/24/2006

Additional Information

Authorized Official

Authorized Official Last Name:
KHAN
Authorized Official First Name:
FAISAL
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
314-615-6445

Provider Taxonomy Codes

  • Taxonomy code: 261QP0905X , 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: 8595 . This is a "HEALTHCAREUSA - NORTH CENTRAL" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 511086308 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8717 . This is a "HEALTHCARE USA SOUTH" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 8283 . This is a "HEALTH CARE USA - JC MURPHY" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 9281 . This is a "HEALTHCARE USA LAKESIDE" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: CC9075 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com