Healthcare Provider Details

I. General information

NPI: 1811048614
Provider Name (Legal Business Name): MERCY REHABILITATION HOSPITAL - ST LOUIS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 08/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14561 NORTH OUTER FORTY ROAD
CHESTERFIELD MO
63017-5703
US

IV. Provider business mailing address

14561 NORTH OUTER FORTY ROAD
CHESTERFIELD MO
63017-5703
US

V. Phone/Fax

Practice location:
  • Phone: 314-881-4006
  • Fax: 314-881-4188
Mailing address:
  • Phone: 314-881-4006
  • Fax: 314-881-4188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License Number
License Number State

VIII. Authorized Official

Name: JERALD RUMPH
Title or Position: CEO
Credential:
Phone: 314-315-0483