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Contact Information

BRENTWOOD PAINSTOP LLC
8045 BIG BEND BLVD STE 107
SAINT LOUIS, MO63119-2714
 Phone: 314-961-7181
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pain Medicine

2081P2900X 25 Physician/Physical Medicine and Rehabilitation
 

Case Manager/Care Coordinator

171M00000X
Indicates primary specialty

NPI Profile & details for BRENTWOOD PAINSTOP LLC

NPI # 1225548290
LBN Legal business name BRENTWOOD PAINSTOP LLC
Authorized official NICHOLAS DIVAN - (CHIROPRACTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 10/04/2017
Last updated 10/04/2017 - About 9 years ago
Identifiers
MO License # 2014010441
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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