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NPI Code Detail

MEDICARE: INTENSIVA HOSPITAL OF GREATER ST. LOUIS INC

MEDICARE: INTENSIVA HOSPITAL OF GREATER ST. LOUIS INC
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
1282E00000XLong Term Care Hospital4582MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1152517OTHERMOBCBS MO
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1275533747
Entity Type Code : Organization
Provider Name (Legal Business Name) : INTENSIVA HOSPITAL OF GREATER ST. LOUIS INC
Provider Business Mailing Address
First Line : 4714 GETTYSBURG RD
Second Line : LEGAL DEPT.
City : MECHANICSBURG
State : PA
Zip : 17055-4325
Country : US
Telephone Number : 717-972-1100
Fax Number : 717-975-9981
Provider Business Practice Location Address
First Line : 300 1ST CAPITOL DR
Second Line :
City : SAINT CHARLES
State : MO
Zip : 63301-2844
Country : US
Telephone Number : 314-768-3450
Fax Number : 314-768-3002
Authorized Official
Title or Position : VICE PRESIDENT
Name : MR. JOHN DUGGAN
Credential :
Telephone Number : 717-972-1100
Provider Enumeration Date : 07/27/2005
Last Update Date : 09/10/2025

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