MEDICARE: MISSOURI BAPTIST MEDICAL CENTER

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	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	2000157562	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2048366	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528017266
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MISSOURI BAPTIST MEDICAL CENTER

Provider Business Mailing Address
First Line	:	3023 N BALLAS RD
Second Line	:	SUITE 100D
City	:	SAINT LOUIS
State	:	MO
Zip	:	63131-2330
Country	:	US
Telephone Number	:	314-657-9008
Fax Number	:	314-996-7544

Provider Business Practice Location Address
First Line	:	3023 N BALLAS RD
Second Line	:	SUITE 100D
City	:	SAINT LOUIS
State	:	MO
Zip	:	63131-2330
Country	:	US
Telephone Number	:	314-657-9008
Fax Number	:	314-996-7544

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ANN ABAD
Credential	:
Telephone Number	:	314-996-8401

Provider Enumeration Date	:	05/09/2006
Last Update Date	:	07/18/2025

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Directions to “MISSOURI BAPTIST MEDICAL CENTER ” Practice Location

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