Healthcare Provider Details

I. General information

NPI: 1306206347
Provider Name (Legal Business Name): SSM HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2016
Last Update Date: 03/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1296 JEFFCO BLVD
ARNOLD MO
63010-2138
US

IV. Provider business mailing address

1524 CLEO CT
HIGH RIDGE MO
63049-1414
US

V. Phone/Fax

Practice location:
  • Phone: 636-321-8610
  • Fax:
Mailing address:
  • Phone: 314-402-5308
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number2015040595
License Number StateMO

VIII. Authorized Official

Name: HEATHER HAWKINS
Title or Position: DIRECTOR OF SSM URGENT CARES
Credential:
Phone: 636-498-7402