Basic Information
| Provider Information | |||||||||
| NPI: | 1821006354 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BARNES JEWISH ST. PETERS HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10 HOSPITAL DR | ||||||||
| Address2: | |||||||||
| City: | SAINT PETERS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 633761659 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6369169000 | ||||||||
| FaxNumber: | 3149963610 | ||||||||
| Practice Location | |||||||||
| Address1: | 10 HOSPITAL DR | ||||||||
| Address2: | |||||||||
| City: | SAINT PETERS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 633761659 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6369169000 | ||||||||
| FaxNumber: | 3149963610 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/03/2006 | ||||||||
| LastUpdateDate: | 10/24/2007 | ||||||||
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| AuthorizedOfficialLastName: | ROSS | ||||||||
| AuthorizedOfficialFirstName: | DAVID | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6369169402 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | BARNES JEWISH ST PETERS HOSPITAL | ||||||||
| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | 357-18 | MO | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
ID Information
| ID | Type | State | Issuer | Description | 0059999 | 01 | AETNA HMO/POS | OTHER | 107313 | 01 | BLUE CROSS | OTHER | 260191 | 01 | MERCY | OTHER | 7676X7676 | 01 | HEALTHCARE USA | OTHER | 102790 | 01 | HEALTH LINK | OTHER | 6350770 | 01 | AETNA PPO | OTHER |