Healthcare Provider Details

I. General information

NPI: 1801889795
Provider Name (Legal Business Name): THE HEART HEALTH CENTER, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2005
Last Update Date: 12/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 N NEW BALLAS RD STE 170W
SAINT LOUIS MO
63141-6835
US

IV. Provider business mailing address

PO BOX 952632 STE 170W
SAINT LOUIS MO
63195-2632
US

V. Phone/Fax

Practice location:
  • Phone: 314-993-6969
  • Fax: 314-993-0792
Mailing address:
  • Phone: 314-993-6969
  • Fax: 314-993-0792

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number StateMO

VIII. Authorized Official

Name: DR. ALLEN D SOFFER
Title or Position: PRESIDENT
Credential: MD
Phone: 314-993-6969