MEDICARE: REPRODUCTIVE HEALTH SERVICES OF PLANNED PARENTHOD GREAT RIVERS

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	261QA0005X	Ambulatory Family Planning Facility	14	MO

General Provider Information

NPI Number	:	1184686511
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REPRODUCTIVE HEALTH SERVICES OF PLANNED PARENTHOD GREAT RIVERS

Provider Business Mailing Address
First Line	:	4251 FOREST PARK AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63108-2810
Country	:	US
Telephone Number	:	314-531-7526
Fax Number	:	314-531-3190

Provider Business Practice Location Address
First Line	:	4251 FOREST PARK AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63108-2810
Country	:	US
Telephone Number	:	314-531-7526
Fax Number	:	314-531-3190

Authorized Official
Title or Position	:	GENERAL COUNSEL
Name	:	RICHARD MUNIZ
Credential	:
Telephone Number	:	314-828-1804

Provider Enumeration Date	:	04/03/2006
Last Update Date	:	08/15/2024

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