Healthcare Provider Details

I. General information

NPI: 1598192452
Provider Name (Legal Business Name): NAUFEL INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2013
Last Update Date: 01/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 S BROADWAY
SAINT LOUIS MO
63111-2015
US

IV. Provider business mailing address

5000 S BROADWAY
SAINT LOUIS MO
63111-2015
US

V. Phone/Fax

Practice location:
  • Phone: 314-752-0000
  • Fax: 314-752-0592
Mailing address:
  • Phone: 314-752-0000
  • Fax: 314-752-0592

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number039812
License Number StateMO

VIII. Authorized Official

Name: GHADIR NAUFEL
Title or Position: ADMINISTRATOR
Credential: RN, LNHA
Phone: 314-752-0000