Provider Demographics
NPI:1073894143
Name:CONCIERGE CARE LLC
Entity Type:Organization
Organization Name:CONCIERGE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:UCHENNA
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:OGBUOKIRI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-703-8609
Mailing Address - Street 1:3535 SOUTH JEFFERSON
Mailing Address - Street 2:STE 104
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63118
Mailing Address - Country:US
Mailing Address - Phone:314-449-1143
Mailing Address - Fax:314-449-1724
Practice Address - Street 1:3535 S JEFFERSON AVE
Practice Address - Street 2:SUITE 114
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63118-3930
Practice Address - Country:US
Practice Address - Phone:314-771-5822
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-02
Last Update Date:2017-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20060253323207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty