Healthcare Provider Details

I. General information

NPI: 1295766087
Provider Name (Legal Business Name): TENET HEALTHSYSTEM DI, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 03/12/2021
Certification Date: 03/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2345 DOUGHERTY FERRY RD
SAINT LOUIS MO
63122-3313
US

IV. Provider business mailing address

PO BOX 741263
ATLANTA GA
30374-1263
US

V. Phone/Fax

Practice location:
  • Phone: 314-966-9100
  • Fax:
Mailing address:
  • Phone: 678-242-2002
  • Fax: 314-966-9274

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0700X
TaxonomyEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center
License Number437-8
License Number StateMO

VIII. Authorized Official

Name: MR. CRAIG C. ARMIN
Title or Position: VP OF GOVT PROGRAMS, TENET
Credential:
Phone: 818-436-2267