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General NPI Number Information
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NPI Number | 1972912087
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Entity Type | Organization
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Legal Business Name | WASHINGTON UNIVERSITY CLINICAL ASSOCIATES BLUE FISH LLC
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Dates
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Enumeration Date | 08/04/2014
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Last Update Date | 05/02/2025
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Provider Practice Location Address
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Address Line | 1000 DES PERES RD STE 280
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City | SAINT LOUIS
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State | MO
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Zip | 63131-2064
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Country | US
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Telephone | 314-996-8500
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7412023
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City | CHICAGO
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State | IL
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Zip | 60674-2011
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Country | US
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Telephone | 314-966-8500
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Fax | 314-966-4499
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Authorized Official
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Title or Position | SENIOR DIRECTOR WU MANAGED CARE
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Name | MS. CATHY EGHIGIAN
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Credential |
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Telephone | 314-273-0770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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