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ST JOHNS CLINIC INC NPI 1013130483


NPI Information

NPI: 1013130483
Provider Name: ST JOHNS CLINIC INC

Doing Business As: SJC-LEBANON-OPTOMETRY

Classification: Durable Medical Equipment & Medical Supplies - 332B00000X
Entity Type: Organization
Address:
331 HOSPITAL DR
SUITE E
LEBANON, MO
ZIP 65536
Phone: (417) 533-6540
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ST JOHNS CLINIC INC is a durable medical equipment medical supplies in Lebanon, MO. The provider is a supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time. ST JOHNS CLINIC INC NPI is 1013130483. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Sjc-lebanon-optometry.

The provider's business location address is:

331 HOSPITAL DR
SUITE E
LEBANON, MO
ZIP 65536-217
Phone: (417) 533-6540
Fax: (417) 533-6550

The provider's authorized official is Donn E. Sorensen .
The authorized official title is Senior Vice President and has the following contact phone number (417) 829-4264.

The enumeration date for this NPI number is 4/11/2007 and was last updated on 9/27/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1156FX1800XTechnician/TechnologistOpticianMISSOURINo
2332B00000XDurable Medical Equipment & Medical SuppliesMISSOURIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10472580043MEDICARE NSCMISSOURI
2329095806MEDICAIDMISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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