Healthcare Provider Details

I. General information

NPI: 1104689207
Provider Name (Legal Business Name): JOSEPH EUAL LOEHMER RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/01/2024
Last Update Date: 02/01/2024
Certification Date: 02/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2845 VETERANS MEMORIAL PKWY
SAINT CHARLES MO
63303-3526
US

IV. Provider business mailing address

2845 VETERANS MEMORIAL PKWY
SAINT CHARLES MO
63303-3526
US

V. Phone/Fax

Practice location:
  • Phone: 314-652-4100
  • Fax: 314-289-6360
Mailing address:
  • Phone: 314-652-4100
  • Fax: 314-289-6360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041371056
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: