Provider Demographics
NPI:1093902850
Name:SAINT LOUIS UNIVERSITY HOSPITAL
Entity Type:Organization
Organization Name:SAINT LOUIS UNIVERSITY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PGY2
Authorized Official - Prefix:
Authorized Official - First Name:OMAR
Authorized Official - Middle Name:SALEH
Authorized Official - Last Name:ABU-ROMEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-489-3123
Mailing Address - Street 1:7514 FLETA ST
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63123-2829
Mailing Address - Country:US
Mailing Address - Phone:314-489-3123
Mailing Address - Fax:
Practice Address - Street 1:3635 VISTA AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-2539
Practice Address - Country:US
Practice Address - Phone:314-577-8000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-26
Last Update Date:2007-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006019866282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital