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Contact Information

BRIDGETON EMERGENCY GROUP LLC
12303 DE PAUL DR
BRIDGETON, MO63044-2512
 Phone: 800-893-9698
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
 

Nurse Practitioner

363L00000X 50 Nurse Practitioner
 

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for BRIDGETON EMERGENCY GROUP LLC

NPI Number 1053660076
LBN Legal business name BRIDGETON EMERGENCY GROUP LLC
Authorized official LISHA FALK - (VP OF CONTRACTING)
Entity Organization
Organization subpart 1 No
Enumeration date 09/05/2012
Last updated 01/14/2016 - About 10 years ago
Identifiers
MO Medicaid 1053660076
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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