Provider Demographics
NPI: | 1427221407 |
---|---|
Name: | WASHINGTON UNIVERSITY |
Entity Type: | Organization |
Organization Name: | WASHINGTON UNIVERSITY |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | DIRECTOR |
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: | 4921 PARKVIEW PL |
Mailing Address - Street 2: | STE A/B |
Mailing Address - City: | SAINT LOUIS |
Mailing Address - State: | MO |
Mailing Address - Zip Code: | 63110-1032 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 314-747-2500 |
Mailing Address - Fax: | 314-747-2598 |
Practice Address - Street 1: | 4921 PARKVIEW PL |
Practice Address - Street 2: | A/B |
Practice Address - City: | SAINT LOUIS |
Practice Address - State: | MO |
Practice Address - Zip Code: | 63110-1032 |
Practice Address - Country: | US |
Practice Address - Phone: | 314-747-2500 |
Practice Address - Fax: | 314-747-2598 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2008-04-10 |
Last Update Date: | 2015-04-09 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 332B00000X | Suppliers | Durable Medical Equipment & Medical Supplies |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
MO | 0255860003 | Medicare NSC |