MEDICARE: PATIENTS FIRST HEALTH CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1174719215
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PATIENTS FIRST HEALTH CARE LLC

Provider Business Mailing Address
First Line	:	901 PATIENTS FIRST DR
Second Line	:
City	:	WASHINGTON
State	:	MO
Zip	:	63090-4700
Country	:	US
Telephone Number	:	636-390-1400
Fax Number	:	636-390-1439

Provider Business Practice Location Address
First Line	:	9513 HIGHWAY 100
Second Line	:
City	:	NEW HAVEN
State	:	MO
Zip	:	63068-1300
Country	:	US
Telephone Number	:	573-237-6100
Fax Number	:	573-237-6103

Authorized Official
Title or Position	:	CHAIRMAN
Name	:	MICHAEL E RAU
Credential	:	M.D.
Telephone Number	:	636-390-1400

Provider Enumeration Date	:	09/21/2007
Last Update Date	:	09/21/2007

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