Basic Information
| Provider Information | |||||||||
| NPI: | 1841208170 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BARNES JEWISH WEST COUNTY HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12634 OLIVE BLVD | ||||||||
| Address2: | |||||||||
| City: | CREVE COEUR | ||||||||
| State: | MO | ||||||||
| PostalCode: | 631416337 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3149968000 | ||||||||
| FaxNumber: | 3149963610 | ||||||||
| Practice Location | |||||||||
| Address1: | 12634 OLIVE BLVD | ||||||||
| Address2: | |||||||||
| City: | CREVE COEUR | ||||||||
| State: | MO | ||||||||
| PostalCode: | 631416337 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3149968000 | ||||||||
| FaxNumber: | 3149963610 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/03/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | MOHRMAN | ||||||||
| AuthorizedOfficialFirstName: | PAT | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3149968400 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | 368-16 | MO | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
ID Information
| ID | Type | State | Issuer | Description | 16 | 01 | BLUE CROSS | OTHER | 0518719 | 01 | AETNA HMO/POS | OTHER | 7723X7723 | 01 | HEALTHCARE USA | OTHER | 117292 | 01 | HEALTH LINK | OTHER | 6350680 | 01 | AETNA PPO | OTHER | 260162 | 01 | MERCY | OTHER |