Healthcare Provider Details

I. General information

NPI: 1376981563
Provider Name (Legal Business Name): SAINT LOUIS CONNECTCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2013
Last Update Date: 06/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5535 DELMAR BLVD
SAINT LOUIS MO
63112-3005
US

IV. Provider business mailing address

5535 DELMAR BLVD
SAINT LOUIS MO
63112-3005
US

V. Phone/Fax

Practice location:
  • Phone: 314-879-6308
  • Fax: 314-879-6372
Mailing address:
  • Phone: 314-879-6308
  • Fax: 314-879-6372

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. MELODY E ESKRIDGE
Title or Position: PRESIDENT/CEO
Credential:
Phone: 314-879-6308