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General NPI Number Information
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NPI Number | 1407740061
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Entity Type | Organization
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Legal Business Name | SSM DEPAUL HEALTH CENTER FOUNDATION
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Dates
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Enumeration Date | 06/06/2025
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Last Update Date | 06/11/2025
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Provider Practice Location Address
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Address Line | 12303 DE PAUL DR
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City | BRIDGETON
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State | MO
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Zip | 63044-2512
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Country | US
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Telephone | 324-344-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 12255 DEPAUL DRIVE SUITE 705
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City | BRIDGETON
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State | MO
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Zip | 63044
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Country | US
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Telephone | 314-344-7545
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Fax |
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Authorized Official
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Title or Position | PODIATRIC RESIDENCY MANAGER
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Name | HOLLY HOPKINS
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Credential |
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Telephone | 314-344-6000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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