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General NPI Number Information
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NPI Number | 1609140359
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Entity Type | Organization
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Legal Business Name | ABUNDANT HEALTH CARE SERVICES
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Dates
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Enumeration Date | 02/27/2012
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Last Update Date | 02/27/2012
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Provider Practice Location Address
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Address Line | 212 CHARMERS CT
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City | KIRKWOOD
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State | MO
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Zip | 63122-7129
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Country | US
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Telephone | 314-664-5155
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Fax | 866-255-9006
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Provider Business Mailing Address
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Address Line | 1712 S TUCKER BLVD
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City | SAINT LOUIS
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State | MO
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Zip | 63104-3427
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Country | US
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Telephone | 314-334-8000
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Fax | 866-255-9006
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. PAMELA VANTRICE GREER
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Credential |
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Telephone | 314-664-5155
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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