Healthcare Provider Details

I. General information

NPI: 1497951412
Provider Name (Legal Business Name): ST. ANDREWS & BETHESDA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2007
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12101 WOODCREST EXECUTIVE DR STE 200
SAINT LOUIS MO
63141-5047
US

IV. Provider business mailing address

12101 WOODCREST EXECUTIVE DR STE 200
SAINT LOUIS MO
63141-5047
US

V. Phone/Fax

Practice location:
  • Phone: 314-800-1900
  • Fax: 314-900-3683
Mailing address:
  • Phone: 314-800-1900
  • Fax: 314-900-3683

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: KIEL PEREGRIN
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 314-800-1900