Provider Demographics
NPI:1164458675
Name:HEART CARE INSTITUTE LLC
Entity Type:Organization
Organization Name:HEART CARE INSTITUTE LLC
Other - Org Name:HEART CARE INSTITUTE CARDIAC DIAGNOSTIC LAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR, CREDENTIALING OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:EGHIGIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-935-0770
Mailing Address - Street 1:7425 FORSYTH BLVD
Mailing Address - Street 2:CAMPUS BOX 8221
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63105-2171
Mailing Address - Country:US
Mailing Address - Phone:314-935-0770
Mailing Address - Fax:314-935-0575
Practice Address - Street 1:1020 N MASON RD
Practice Address - Street 2:SUITE 130
Practice Address - City:CREVE COEUR
Practice Address - State:MO
Practice Address - Zip Code:63141-6300
Practice Address - Country:US
Practice Address - Phone:314-996-3110
Practice Address - Fax:314-996-3129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0404XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Cardiac Facilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO000093029Medicare PIN
MO470000938Medicare PIN