Healthcare Provider Details

I. General information

NPI: 1750025565
Provider Name (Legal Business Name): BARNES JEWISH HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2022
Last Update Date: 11/15/2024
Certification Date: 11/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1234 S KINGSHIGHWAY BLVD STE 1900
SAINT LOUIS MO
63110-2170
US

IV. Provider business mailing address

1 BARNES JEWISH HOSPITAL PLZ MAILSTOP 90-71-307
SAINT LOUIS MO
63110
US

V. Phone/Fax

Practice location:
  • Phone: 314-657-9012
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: PAUL IROVIC
Title or Position: VICE PRESIDENT
Credential:
Phone: 314-265-8874