Healthcare Provider Details

I. General information

NPI: 1205898574
Provider Name (Legal Business Name): PLANNED PARENTHOOD GREAT RIVERS-MISSOURI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2006
Last Update Date: 07/31/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4251 FOREST PARK AVE
SAINT LOUIS MO
63108-2810
US

IV. Provider business mailing address

4251 FOREST PARK AVE
SAINT LOUIS MO
63108-2810
US

V. Phone/Fax

Practice location:
  • Phone: 314-531-7526
  • Fax: 314-531-3190
Mailing address:
  • Phone: 314-531-7526
  • Fax: 314-531-3190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number2009004523
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code261QF0050X
TaxonomyNon-Surgical Family Planning Clinic/Center
License Number520524208
License Number StateMO

VIII. Authorized Official

Name: KATIE KLEIN
Title or Position: VP OF BUSINESS OP
Credential:
Phone: 314-531-7526