Provider Demographics
NPI:1164293296
Name:DOVER HEALTH PALLIATIVE CARE MO LLC
Entity Type:Organization
Organization Name:DOVER HEALTH PALLIATIVE CARE MO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BURGHART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-451-5606
Mailing Address - Street 1:300 HUNTER AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63124-2328
Mailing Address - Country:US
Mailing Address - Phone:314-451-5606
Mailing Address - Fax:314-627-4890
Practice Address - Street 1:300 HUNTER AVE STE 107
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63124-2081
Practice Address - Country:US
Practice Address - Phone:314-451-5606
Practice Address - Fax:314-627-4890
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DOVER HEALTH LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-01-09
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Single Specialty