Healthcare Provider Details

I. General information

NPI: 1295890150
Provider Name (Legal Business Name): WASHINGTON UNIVERSITY CARE COORDINATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7425 FORSYTH BLVD CAMPUS BOX 1238
SAINT LOUIS MO
63105-2171
US

IV. Provider business mailing address

7425 FORSYTH BLVD CAMPUS BOX 8221
SAINT LOUIS MO
63105-2171
US

V. Phone/Fax

Practice location:
  • Phone: 314-935-0667
  • Fax: 314-935-0440
Mailing address:
  • Phone: 314-935-0681
  • Fax: 314-935-0575

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. JACKIE REED
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 314-935-0667