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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 Specialty Code Provider Type

Preferred Provider Organization

305R00000X
Indicates primary specialty

NPI Profile & details for SOUTH COUNTY EYE CARE

NPI Number 1801981899
LBN Legal business name SOUTH COUNTY EYE CARE
Authorized official BRANDI POLK - (ADMIN)
Entity Organization
Organization subpart 1 No
Enumeration date 10/04/2006
Last updated 02/19/2019 - About 7 years ago
Identifiers
MO License # MDR9N88
MO Medicaid 203015219
MO Other MDR9N88 MO LICENSE #
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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