Provider Demographics
NPI:1437178522
Name:BARNES JEWISH HOSPITAL
Entity Type:Organization
Organization Name:BARNES JEWISH HOSPITAL
Other - Org Name:BARNES-JEWISH EXTENDED CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE-PRESIDENT AND CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:KRIEGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-854-1174
Mailing Address - Street 1:401 CORPORATE PARK DR
Mailing Address - Street 2:MAIL STOP #91
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63105-4201
Mailing Address - Country:US
Mailing Address - Phone:314-854-1154
Mailing Address - Fax:314-854-1174
Practice Address - Street 1:401 CORPORATE PARK DR
Practice Address - Street 2:MAIL STOP #91
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63105-4201
Practice Address - Country:US
Practice Address - Phone:314-725-7447
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BARNES JEWISH HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-19
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO031951314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
7684261OtherAETNA
7100015OtherUNITED HEALTHCARE
MO102907003Medicaid
106309OtherBLUE CROSS BLUE SHIELD
236817OtherHEALTHLINK
640OtherGHP
236817OtherHEALTHLINK
640OtherGHP
106309OtherBLUE CROSS BLUE SHIELD
=========OtherCIGNA
640OtherGHP