Provider Demographics
NPI:1497912943
Name:NEW HORIZONS HEALTHCARE LLC
Entity Type:Organization
Organization Name:NEW HORIZONS HEALTHCARE LLC
Other - Org Name:NEW HORIZONS HEALTHCARE LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PHYSICIAN/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:RENFERT
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:636-825-1510
Mailing Address - Street 1:2961 DOUGHERTY FERRY RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63122-3374
Mailing Address - Country:US
Mailing Address - Phone:636-825-1510
Mailing Address - Fax:636-825-1560
Practice Address - Street 1:2961 DOUGHERTY FERRY RD
Practice Address - Street 2:SUITE 106
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63122-3374
Practice Address - Country:US
Practice Address - Phone:636-825-1510
Practice Address - Fax:636-825-1560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOH35117Medicare UPIN