Healthcare Provider Details

I. General information

NPI: 1700836897
Provider Name (Legal Business Name): HLS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 10/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3645 OAKMOUNT AVE
SAINT LOUIS MO
63121
US

IV. Provider business mailing address

3645 OAKMOUNT AVE
SAINT LOUIS MO
63121
US

V. Phone/Fax

Practice location:
  • Phone: 314-382-8899
  • Fax: 314-382-4002
Mailing address:
  • Phone: 314-382-8899
  • Fax: 314-382-4002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. GERALDINE SCOTT
Title or Position: BUS MANAGER VICE PRESIDENT
Credential:
Phone: 314-382-8899