Healthcare Provider Details
I. General information
NPI: 1053341867
Provider Name (Legal Business Name): HEALTHWEST,LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/04/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1111 E 6TH ST
WASHINGTON MO
63090-3308
US
IV. Provider business mailing address
2203 DEVONSBROOK DR
CHESTERFIELD MO
63005-4519
US
V. Phone/Fax
- Phone: 636-239-1766
- Fax: 636-239-2964
- Phone: 314-330-4587
- Fax: 636-530-9702
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
VIACHESLAV
PLATONOV
Title or Position: MANAGER
Credential: MD
Phone: 314-330-4587