Provider Demographics
NPI:1053651885
Name:VISITING NURSE ASSOCIATION OF GREATER ST. LOUIS
Entity Type:Organization
Organization Name:VISITING NURSE ASSOCIATION OF GREATER ST. LOUIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL VICE PRESIDENT, FINANCE
Authorized Official - Prefix:MS
Authorized Official - First Name:KARI
Authorized Official - Middle Name:
Authorized Official - Last Name:KRUEGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-260-3567
Mailing Address - Street 1:2029 WOODLAND PKWY STE 105
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63146-4267
Mailing Address - Country:US
Mailing Address - Phone:314-918-7171
Mailing Address - Fax:314-513-9950
Practice Address - Street 1:2029 WOODLAND PKWY STE 105
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63146-4267
Practice Address - Country:US
Practice Address - Phone:314-918-7171
Practice Address - Fax:314-513-9950
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SSM HEALTH BUSINESSES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-02-14
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
163WC1500X
MON00028650251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251G00000XAgenciesHospice Care, Community Based
No163WC1500XNursing Service ProvidersRegistered NurseCommunity HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO261505Medicare Oscar/Certification