MEDICARE: ONYX TRANSITIONAL CARE CENTERS, 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
1	207X00000X	Orthopaedic Surgery Physician

General Provider Information

NPI Number	:	1740097716
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ONYX TRANSITIONAL CARE CENTERS, LLC

Provider Business Mailing Address
First Line	:	425 N NEW BALLAS RD STE 230
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63141-6848
Country	:	US
Telephone Number	:	314-266-2066
Fax Number	:	314-266-2069

Provider Business Practice Location Address
First Line	:	425 N NEW BALLAS RD STE 230
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63141-6848
Country	:	US
Telephone Number	:	314-266-2066
Fax Number	:	314-266-2069

Authorized Official
Title or Position	:	OWNER/MANAGER
Name	:	DAVID MINGES
Credential	:	MD
Telephone Number	:	314-266-2066

Provider Enumeration Date	:	12/13/2024
Last Update Date	:	12/13/2024

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