Provider Demographics
NPI:1336470129
Name:CRITICAL CARE SERVICES INC
Entity Type:Organization
Organization Name:CRITICAL CARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP MEDICAL AFFAIRS
Authorized Official - Prefix:
Authorized Official - First Name:ISABELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:KOPEC
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-514-5000
Mailing Address - Street 1:999 EXECUTIVE PARKWAY DR STE 210
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-6336
Mailing Address - Country:US
Mailing Address - Phone:314-514-5000
Mailing Address - Fax:
Practice Address - Street 1:999 EXECUTIVE PARKWAY DR
Practice Address - Street 2:SUITE 210
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-6336
Practice Address - Country:US
Practice Address - Phone:314-514-6000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-19
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Multi-Specialty