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Contact Information

MODERN VASCULAR OF ST LOUIS LLC
641 N NEW BALLAS RD
CREVE COEUR, MO63141-6713
 Phone: 314-648-0101
 Fax: 314-899-2715
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Vascular & Interventional Radiology

2085R0204X 94 Physician/Interventional Radiology
 

Vascular-Interventional Technology Radiologic Technologist

2471V0106X
Indicates primary specialty

NPI Profile & details for MODERN VASCULAR OF ST LOUIS LLC

NPI Number 1972106391
LBN Legal business name MODERN VASCULAR OF ST LOUIS LLC
Authorized official YURY GAMPEL - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 11/18/2020
Last updated 11/18/2020 - About 6 years ago
Identifiers n/a
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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