Healthcare Provider Details

I. General information

NPI: 1144432352
Provider Name (Legal Business Name): MISSOURI VETERANS COMMISSION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10600 LEWIS AND CLARK BLVD
SAINT LOUIS MO
63136-6005
US

IV. Provider business mailing address

10600 LEWIS AND CLARK BLVD
SAINT LOUIS MO
63136-6005
US

V. Phone/Fax

Practice location:
  • Phone: 314-340-6389
  • Fax: 314-340-6379
Mailing address:
  • Phone: 314-340-6389
  • Fax: 314-340-6379

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateMO

VIII. Authorized Official

Name: MR. MICHAEL F. BARTH
Title or Position: ADMINISTRATOR
Credential: MBA
Phone: 314-340-6389