Healthcare Provider Details

I. General information

NPI: 1922295815
Provider Name (Legal Business Name): PATIENTS FIRST HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2007
Last Update Date: 09/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 GRANDE CTR
SULLIVAN MO
63080-1266
US

IV. Provider business mailing address

901 PATIENTS FIRST DR
WASHINGTON MO
63090-4700
US

V. Phone/Fax

Practice location:
  • Phone: 573-468-4455
  • Fax: 573-468-4451
Mailing address:
  • Phone: 636-390-1400
  • Fax: 636-390-1439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL E RAU
Title or Position: CHAIRMAN
Credential: M.D.
Phone: 636-390-1400