Basic Information
| Provider Information | |||||||||
| NPI: | 1316175417 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | URGENT CARE CENTERS OF ST. ANTHONY'S MEDICAL CENTER, LC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10010 KENNERLY RD | ||||||||
| Address2: | |||||||||
| City: | SAINT LOUIS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 631282106 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3145251000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3619 RICHARDSON SQUARE DR | ||||||||
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| City: | ARNOLD | ||||||||
| State: | MO | ||||||||
| PostalCode: | 630106022 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6367176700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2009 | ||||||||
| LastUpdateDate: | 02/26/2016 | ||||||||
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| AuthorizedOfficialLastName: | MORTON | ||||||||
| AuthorizedOfficialFirstName: | DAVID | ||||||||
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| AuthorizedOfficialTitleorPosition: | CMO | ||||||||
| AuthorizedOfficialTelephone: | 3145251000 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | ST. ANTHONY'S MEDICAL CENTER | ||||||||
| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 273-34 | MO | Y | Hospitals | General Acute Care Hospital |
No ID Information.