SAINT LOUIS RENAL CARE LLC NPI 1013029982

NPI Information

NPI: 1013029982
Provider Name: SAINT LOUIS RENAL CARE, LLC

Doing Business As: ST. LOUIS RENAL CARE - DES PERES

Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
2325 DOUGHERTY FERRY RD
MEDICAL ARTS PAVILLON SUITE 103
SAINT LOUIS, MO
ZIP 63122
Phone: (314) 822-8963
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SAINT LOUIS RENAL CARE, LLC is an end-stage renal disease (esrd) treatment clinic center in Saint Louis, MO. SAINT LOUIS RENAL CARE, LLC NPI is 1013029982. The provider is registered as an organization entity type.
The provider Is Doing Business As St. Louis Renal Care - Des Peres.

The provider's business location address is:

2325 DOUGHERTY FERRY RD
MEDICAL ARTS PAVILLON SUITE 103
SAINT LOUIS, MO
ZIP 63122-356
Phone: (314) 822-8963

The provider's authorized official is Mark Fawcett .
The authorized official title is Treasurer and has the following contact phone number (781) 699-9000.

The CLIA number assigned to this NPI record is 26D1046774 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 8/31/2006 and was last updated on 12/31/2012.

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
1	261QE0700X	Clinic/Center	End-Stage Renal Disease (ESRD) Treatment			Yes

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
1	262594	MEDICARE OSCAR/CERTIFICATION

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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