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General NPI Number Information
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NPI Number | 1164882775
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Entity Type | Organization
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Legal Business Name | WUCA-NASH PEDIATRICS, LLC
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Dates
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Enumeration Date | 02/25/2016
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Last Update Date | 04/29/2025
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Provider Practice Location Address
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Address Line | 3737 N KINGSHIGHWAY BLVD SUITE 209
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City | SAINT LOUIS
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State | MO
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Zip | 63115-1736
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Country | US
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Telephone | 314-261-5250
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Fax | 314-261-4567
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Provider Business Mailing Address
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Address Line | PO BOX 7412039
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City | CHICAGO
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State | IL
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Zip | 60674-2011
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Country | US
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Telephone | 314-261-5250
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Fax | 314-261-4567
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Authorized Official
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Title or Position | SENIOR DIRECTOR WU MANAGED CARE
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Name | CATHY EGHIGIAN
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Credential |
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Telephone | 314-273-0770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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