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NPI Code Detail

MEDICARE: SSM HEALTH CARE ST. LOUIS

MEDICARE: SSM HEALTH CARE ST. LOUIS
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
1314000000XSkilled Nursing Facility41410MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1346237112
Entity Type Code : Organization
Provider Name (Legal Business Name) : SSM HEALTH CARE ST. LOUIS
Provider Business Mailing Address
First Line : 12303 DEPAUL DR.
Second Line :
City : BRIDGETON
State : MO
Zip : 63044-2512
Country : US
Telephone Number : 314-209-8814
Fax Number : 314-209-8823
Provider Business Practice Location Address
First Line : 12303 DEPAUL DR.
Second Line :
City : BRIDGETON
State : MO
Zip : 63044-2512
Country : US
Telephone Number : 314-209-8814
Fax Number : 314-209-8823
Authorized Official
Title or Position : HOSPITAL PRESIDENT
Name : MR. ELLIS D. HAWKINS
Credential :
Telephone Number : 314-344-7210
Provider Enumeration Date : 10/05/2005
Last Update Date : 08/15/2019

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Directions to “SSM HEALTH CARE ST. LOUIS ” Practice Location

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