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General NPI Number Information
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NPI Number | 1548878705
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Entity Type | Organization
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Legal Business Name | CHRISTIAN HOSPITAL NORTHEAST NORTHWEST
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Dates
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Enumeration Date | 07/14/2020
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Last Update Date | 03/18/2021
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Provider Practice Location Address
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Address Line | 11133 DUNN RD
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City | SAINT LOUIS
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State | MO
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Zip | 63136-6163
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Country | US
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Telephone | 314-653-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 11133 DUNN RD
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City | SAINT LOUIS
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State | MO
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Zip | 63136-6163
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT, CFO
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Name | SUSAN C KOESTERER
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Credential |
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Telephone | 314-653-5034
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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