Provider Demographics
NPI:1275014953
Name:ARCH PEDIATRICS LLC
Entity Type:Organization
Organization Name:ARCH PEDIATRICS LLC
Other - Org Name:ARCH PEDIATRICS
Other - Org Type:Other Name
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:314-273-0770
Mailing Address - Street 1:3844 S LINDBERGH BLVD STE 216
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63127-1369
Mailing Address - Country:US
Mailing Address - Phone:314-525-0580
Mailing Address - Fax:314-525-0581
Practice Address - Street 1:3844 S LINDBERGH BLVD STE 216
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63127-1369
Practice Address - Country:US
Practice Address - Phone:314-525-0580
Practice Address - Fax:314-525-0581
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-22
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty