ENDOSCOPY CENTER OF ST. LOUIS; NPI #1023094836

Contact Information

ENDOSCOPY CENTER OF ST. LOUIS

200 BREVCO PLAZA
SUITE 207
LAKE SAINT LOUIS, MO 63367

Phone: 636-561-5450
Fax: 636-561-5451
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Endoscopy	261QE0800X

Indicates primary specialty

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NPI Profile & details for ENDOSCOPY CENTER OF ST. LOUIS

NPI # 1023094836

LBN Legal business name ENDOSCOPY CENTER OF ST. LOUIS

Authorized official JAMES PETERSEN - (PRESIDENT)

Entity Organization

Organization subpart ¹ No

Enumeration date 12/22/2005

Last updated 11/27/2007 - About 19 years ago

Identifiers

MO	License #	152-0
MO	Other	195965	BCBS
MO	Other	P00214935	RAIL ROAD MEDICARE

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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