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NPI Code Detail

MEDICARE: COMMUNICARE ELITE, LLC

MEDICARE: COMMUNICARE ELITE, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1302R00000XHealth Maintenance Organization100572MO

General Provider Information

NPI Number : 1194159053
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMMUNICARE ELITE, LLC
Provider Business Mailing Address
First Line : 5203 CHIPPEWA ST
Second Line : SUITE 301
City : SAINT LOUIS
State : MO
Zip : 63109-2356
Country : US
Telephone Number : 314-481-5000
Fax Number : 314-481-3037
Provider Business Practice Location Address
First Line : 5203 CHIPPEWA ST
Second Line : SUITE 301
City : SAINT LOUIS
State : MO
Zip : 63109-2356
Country : US
Telephone Number : 314-481-5000
Fax Number : 314-481-3037
Authorized Official
Title or Position : OWNER
Name : GURPREET PADDA
Credential : M.D
Telephone Number : 314-481-5000
Provider Enumeration Date : 08/28/2013
Last Update Date : 08/28/2013

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Directions to “COMMUNICARE ELITE, LLC ” Practice Location

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