Provider Demographics
NPI:1639741259
Name:ST LOUIS CHILDRENS HOSPITAL
Entity Type:Organization
Organization Name:ST LOUIS CHILDRENS HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-454-6044
Mailing Address - Street 1:1 CHILDRENS PL STE 3S-36
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1002
Mailing Address - Country:US
Mailing Address - Phone:314-454-6044
Mailing Address - Fax:
Practice Address - Street 1:5114 MID AMERICA PLZ STE 1B
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63129-0003
Practice Address - Country:US
Practice Address - Phone:314-657-9009
Practice Address - Fax:314-454-4374
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-13
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy