Healthcare Provider Details

I. General information

NPI: 1437109766
Provider Name (Legal Business Name): FOREST PARK HOSPITAL CORP #1
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6150 OAKLAND AVE
SAINT LOUIS MO
63139-3215
US

IV. Provider business mailing address

531 PEBBLE BROOK LN HMAI
BELLEVILLE IL
62221-7609
US

V. Phone/Fax

Practice location:
  • Phone: 314-768-3090
  • Fax: 314-768-3031
Mailing address:
  • Phone: 618-779-5508
  • Fax: 618-206-8588

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. JERRIE K WEITH
Title or Position: BUSINESS ADVISOR
Credential: FHFMA
Phone: 618-779-5508