Healthcare Provider Details

I. General information

NPI: 1083454920
Provider Name (Legal Business Name): UNIVERSAL FIRST ASSIST ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2024
Last Update Date: 07/15/2024
Certification Date: 06/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

832 BROCKWELL DR
DARDENNE PRAIRIE MO
63368-8370
US

IV. Provider business mailing address

832 BROCKWELL DR
DARDENNE PRAIRIE MO
63368-8370
US

V. Phone/Fax

Practice location:
  • Phone: 314-368-4842
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: PATRICIA HOLSCHEN
Title or Position: RNFA
Credential:
Phone: 314-368-4842