Healthcare Provider Details

I. General information

NPI: 1841547072
Provider Name (Legal Business Name): BARNES-JEWISH HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2012
Last Update Date: 08/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 S KINGSHIGHWAY BLVD APT 9U
SAINT LOUIS MO
63108-1356
US

IV. Provider business mailing address

18 S KINGSHIGHWAY BLVD APT 9U
SAINT LOUIS MO
63108-1356
US

V. Phone/Fax

Practice location:
  • Phone: 314-362-2809
  • Fax: 314-362-2806
Mailing address:
  • Phone: 314-362-2809
  • Fax: 314-362-2806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code281P00000X
TaxonomyChronic Disease Hospital
License Number5436783944
License Number StateMO

VIII. Authorized Official

Name: DR. HENRY ROYAL
Title or Position: PROGRAM DIRECTOR
Credential: MD
Phone: 314-362-2812