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General NPI Number Information
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NPI Number | 1770170524
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Entity Type | Organization
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Legal Business Name | SA HOSPITAL ACQUISITION GROUP, LLC
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Dates
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Enumeration Date | 12/28/2020
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Last Update Date | 03/29/2023
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Provider Practice Location Address
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Address Line | 3933 S BROADWAY
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City | SAINT LOUIS
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State | MO
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Zip | 63118-4601
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Country | US
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Telephone | 314-865-7902
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Fax |
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Provider Business Mailing Address
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Address Line | 3933 S BROADWAY
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City | SAINT LOUIS
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State | MO
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Zip | 63118-4601
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Country | US
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Telephone | 314-865-7902
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | BIANCA DEFILIPPI
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Credential |
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Telephone | 314-865-7917
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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