1467521146 NPI number — SSM HEALTH CARE ST. LOUIS

Table of content: (NPI 1467521146)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467521146 NPI number — SSM HEALTH CARE ST. LOUIS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SSM HEALTH CARE ST. LOUIS
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:
6
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:
1467521146
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/27/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
300 1ST CAPITOL DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAINT CHARLES
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63301-2844
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
636-947-5000
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
300 1ST CAPITOL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAINT CHARLES
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63301-2844
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
636-947-5000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WESCOTT
Authorized Official First Name:
LISLE
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
636-947-5076

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  494-0 , 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: 911244800 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 04782395 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 43065267100 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 797508 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9810174000 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 430652671003 , issued by the state of ( IL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0072433 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 010418101 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 540418100 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: XHSP33509 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: XHSP43509 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 01400399 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 155128105 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 430652671403 , issued by the state of ( IL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1703192 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100398550A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200023220A , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".
  • Identifier: 287522852A , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".




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