Healthcare Provider Details

I. General information

NPI: 1073894143
Provider Name (Legal Business Name): CONCIERGE CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2011
Last Update Date: 03/05/2025
Certification Date: 03/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

536 N TAYLOR AVE
SAINT LOUIS MO
63108-1888
US

IV. Provider business mailing address

536 N TAYLOR AVE
SAINT LOUIS MO
63108-1888
US

V. Phone/Fax

Practice location:
  • Phone: 314-449-1143
  • Fax: 314-449-1724
Mailing address:
  • Phone: 314-449-1143
  • Fax: 314-449-1724

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number20060253323
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: UCHENNA CHRISTOPHER OGBUOKIRI
Title or Position: PHYSICIAN
Credential: MD
Phone: 314-703-8609