Provider Demographics
NPI:1275265167
Name:SSM HEALTH CARE ST LOUIS
Entity Type:Organization
Organization Name:SSM HEALTH CARE ST LOUIS
Other - Org Name:SSM HEALTH SPECIALTY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:V.P. PHARMACY SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:SPENCER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-989-2588
Mailing Address - Street 1:3662 PARK AVE STE 155
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-2512
Mailing Address - Country:US
Mailing Address - Phone:833-354-2223
Mailing Address - Fax:833-354-2219
Practice Address - Street 1:3662 PARK AVE STE 155
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-2512
Practice Address - Country:US
Practice Address - Phone:855-847-3553
Practice Address - Fax:855-847-3558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-29
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy