National Provider Identifier Database

SOUTH COUNTY EYE CARE
Preferred Provider Organization

A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level.


Contact Information

SOUTH COUNTY EYE CARE
13131 TESSON FERRRY RD #108
SAINT LOUIS, MO63128
Phone: 314-843-5800
Fax: 314-843-5290
Website:
Specialty Taxonomy Code
* Preferred Provider Organization 305R00000X

* Indicates primary specialty

NPI Profile & details for SOUTH COUNTY EYE CARE

NPI Number 1801981899
Legal business name
LBN
SOUTH COUNTY EYE CARE
Authorized official BRANDI POLK - (ADMIN)
Entity Organization
Organization subpart No
Enumeration date 10/04/2006
Last updated 02/19/2019 - About 7 years ago
Sole proprietor1 Not specified
Identifiers
  • MO License #: MDR9N88
  • MO Medicaid: 203015219
  • MO Other: MDR9N88 MO LICENSE #

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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