Provider Demographics
NPI:1164726758
Name:THE HEART SPECIALTY ASSOCIATES, LLC
Entity Type:Organization
Organization Name:THE HEART SPECIALTY ASSOCIATES, LLC
Other - Org Name:MERCY CLINIC SOUTH HEART AND VASCULAR PHYSICIANS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:HOEFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-525-1766
Mailing Address - Street 1:PO BOX 776084
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6084
Mailing Address - Country:US
Mailing Address - Phone:314-364-4200
Mailing Address - Fax:314-997-3248
Practice Address - Street 1:10012 KENNERLY RD STE 403
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-2197
Practice Address - Country:US
Practice Address - Phone:314-880-6676
Practice Address - Fax:314-842-4372
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE HEART SPECIALTY ASSOCIATES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-12-22
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac ElectrophysiologyGroup - Multi-Specialty
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear CardiologyGroup - Multi-Specialty