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PREMIER PEDIATRICS LLC NPI 1083195762


NPI Information

NPI: 1083195762
Provider Name: PREMIER PEDIATRICS LLC

Other Name: PREMIER PEDIATRICS

Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

CLIA Number: 26D2156056

Address:
5114 MID AMERICA PLZ STE 2C
SAINT LOUIS, MO
ZIP 63129
Phone: (314) 859-4000
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PREMIER PEDIATRICS LLC is a multi-specialty clinic center in Saint Louis, MO. PREMIER PEDIATRICS LLC NPI is 1083195762. The provider is registered as an organization entity type.
The provider Other Name Is Premier Pediatrics.

The provider's business location address is:

5114 MID AMERICA PLZ STE 2C
SAINT LOUIS, MO
ZIP 63129-003
Phone: (314) 859-4000
Fax: (314) 273-4110

The provider's authorized official is Cathy Eghigian .
The authorized official title is Director, Credentialing Operations and has the following contact phone number (314) 273-0770.

The CLIA number assigned to this NPI record is 26D2156056 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/22/2018 and was last updated on 11/6/2023.


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
1261QM1300XClinic/CenterMulti-SpecialtyYes

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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