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General NPI Number Information
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NPI Number | 1356362586
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Entity Type | Organization
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Legal Business Name | ST LOUIS CHILDREN'S HOSPITAL
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Dates
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Enumeration Date | 07/22/2006
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Last Update Date | 03/16/2021
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Provider Practice Location Address
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Address Line | 1 CHILDRENS PL
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City | SAINT LOUIS
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State | MO
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Zip | 63110-1002
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Country | US
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Telephone | 314-286-2373
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Fax | 314-286-2693
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Provider Business Mailing Address
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Address Line | PO BOX 956190
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City | SAINT LOUIS
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State | MO
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Zip | 63195-0001
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Country | US
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Telephone | 314-286-2373
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Fax | 314-286-2693
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. TRISHA LOLLO
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Credential |
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Telephone | 314-996-8401
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0700X
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Taxonomy Name | End-Stage Renal Disease (ESRD) Treatment Clinic/Center
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License Number | 324-26
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License Number State | MO
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