Healthcare Provider Details

I. General information

NPI: 1831420082
Provider Name (Legal Business Name): UCSL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2010
Last Update Date: 01/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

76 HILLTOP VILLAGE CENTER DR
EUREKA MO
63025-1189
US

IV. Provider business mailing address

76 HILLTOP VILLAGE CENTER DR
EUREKA MO
63025-1189
US

V. Phone/Fax

Practice location:
  • Phone: 314-210-4807
  • Fax: 314-436-9301
Mailing address:
  • Phone: 314-210-4807
  • Fax: 314-436-9301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number261592619
License Number StateMO

VIII. Authorized Official

Name: MR. SONNY S SAGGAR
Title or Position: CEO
Credential: MD
Phone: 314-436-9300