Healthcare Provider Details

I. General information

NPI: 1821006354
Provider Name (Legal Business Name): BARNES JEWISH ST. PETERS HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 10/24/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 HOSPITAL DR
SAINT PETERS MO
63376-1659
US

IV. Provider business mailing address

10 HOSPITAL DR
SAINT PETERS MO
63376-1659
US

V. Phone/Fax

Practice location:
  • Phone: 636-916-9000
  • Fax: 314-996-3610
Mailing address:
  • Phone: 636-916-9000
  • Fax: 314-996-3610

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number357-18
License Number StateMO

VIII. Authorized Official

Name: MR. DAVID ROSS
Title or Position: PRESIDENT
Credential:
Phone: 636-916-9402