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General NPI Number Information
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NPI Number | 1962432492
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Entity Type | Organization
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Legal Business Name | SIGNATURE HEALTH SERVICES
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Dates
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Enumeration Date | 07/03/2006
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Last Update Date | 10/28/2025
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Provider Practice Location Address
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Address Line | 12639 OLD TESSON ROAD SUITE 125
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City | SAINT LOUIS
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State | MO
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Zip | 63128-2786
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Country | US
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Telephone | 314-849-0311
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Fax | 314-849-4423
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Provider Business Mailing Address
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Address Line | 12639 OLD TESSON RD STE 115
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City | SAINT LOUIS
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State | MO
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Zip | 63128-2786
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Country | US
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Telephone | 314-849-0311
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Fax | 314-849-4423
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Authorized Official
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Title or Position | CEO
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Name | MR. CHAD SACKMAN
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Credential |
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Telephone | 314-849-0311
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM1200X
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Taxonomy Name | Magnetic Resonance Imaging (MRI) Clinic/Center
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License Number |
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License Number State |
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