Healthcare Provider Details

I. General information

NPI: 1366529364
Provider Name (Legal Business Name): KINDRED HOSPITALS EAST, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 03/11/2024
Certification Date: 03/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10018 KENNERLY RD 3RD FLOOR, HYLAND BLDG. B
SAINT LOUIS MO
63128-2106
US

IV. Provider business mailing address

10018 KENNERLY RD 3RD FLOOR, HYLAND BLDG. B
SAINT LOUIS MO
63128-2106
US

V. Phone/Fax

Practice location:
  • Phone: 314-525-8100
  • Fax: 314-525-8199
Mailing address:
  • Phone: 314-525-8100
  • Fax: 314-525-8199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282E00000X
TaxonomyLong Term Care Hospital
License Number444-7
License Number StateMO

VIII. Authorized Official

Name: KATHY TEAGUE
Title or Position: VICE PRESIDENT, CORPORATE SECRETARY
Credential:
Phone: 629-253-5121