Healthcare Provider Details

I. General information

NPI: 1922112622
Provider Name (Legal Business Name): ARS PEDIATRICS, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9553 LACKLAND RD
SAINT LOUIS MO
63114-3640
US

IV. Provider business mailing address

9553 LACKLAND RD
SAINT LOUIS MO
63114-3640
US

V. Phone/Fax

Practice location:
  • Phone: 314-729-7733
  • Fax: 314-429-3194
Mailing address:
  • Phone: 314-729-7733
  • Fax: 314-429-3194

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: VIRGINIA GALKOWSKI
Title or Position: OWNER
Credential: R.N.
Phone: 314-429-7733