Provider Demographics
NPI:1245791474
Name:WOMEN'S CARE OF ST LUKE'S, LLC
Entity Type:Organization
Organization Name:WOMEN'S CARE OF ST LUKE'S, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:V. P. PHYSICIAN NETWORK
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:SNIDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:636-685-7804
Mailing Address - Street 1:226 S WOODS MILL RD STE 55W
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-3664
Mailing Address - Country:US
Mailing Address - Phone:314-542-4953
Mailing Address - Fax:314-590-5942
Practice Address - Street 1:226 S WOODS MILL RD STE 55W
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-3664
Practice Address - Country:US
Practice Address - Phone:314-542-4953
Practice Address - Fax:314-590-5942
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST. LUKES MEDICAL GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-03-29
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty