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NPI Code Detail

MEDICARE: SSM REGIONAL HEALTH SERVICES

MEDICARE: SSM REGIONAL HEALTH SERVICES
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
1261Q00000XClinic/Center

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 : 1396782587
Entity Type Code : Organization
Provider Name (Legal Business Name) : SSM REGIONAL HEALTH SERVICES
Provider Business Mailing Address
First Line : 7655 SOLUTIONS CTR
Second Line :
City : CHICAGO
State : IL
Zip : 60677-7006
Country : US
Telephone Number : 557-203-1551
Fax Number : 314-989-6721
Provider Business Practice Location Address
First Line : 3348 AMERICAN AVE
Second Line :
City : JEFFERSON CITY
State : MO
Zip : 65109-1079
Country : US
Telephone Number : 573-761-7210
Fax Number : 573-634-8802
Authorized Official
Title or Position : REGIONAL VICE PRESIDENT FINANCE/CFO
Name : SHASTA RENE MANUEL
Credential :
Telephone Number : 405-272-7282
Provider Enumeration Date : 05/31/2006
Last Update Date : 12/16/2025

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Directions to “SSM REGIONAL HEALTH SERVICES ” Practice Location

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