Healthcare Provider Details
I. General information
NPI: 1164824652
Provider Name (Legal Business Name): HHC HEALTH CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/16/2014
Last Update Date: 09/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
450 N NEW BALLAS RD STE 270 WEST WING
SAINT LOUIS MO
63141-6835
US
IV. Provider business mailing address
450 N NEW BALLAS RD STE 270 WEST WING
SAINT LOUIS MO
63141-6835
US
V. Phone/Fax
- Phone: 314-993-6969
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ALLEN
SOFFER
Title or Position: PRESIDENT
Credential: MD
Phone: 314-993-6969