Provider Demographics
NPI:1659155950
Name:ST. LOUIS FERTILITY SERVICES, LLC
Entity Type:Organization
Organization Name:ST. LOUIS FERTILITY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, RCM
Authorized Official - Prefix:
Authorized Official - First Name:TARA
Authorized Official - Middle Name:
Authorized Official - Last Name:SELLERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-321-6118
Mailing Address - Street 1:6720 N SCOTTSDALE RD STE 160
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85253-4421
Mailing Address - Country:US
Mailing Address - Phone:480-321-6118
Mailing Address - Fax:
Practice Address - Street 1:15320 CONWAY RD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-2019
Practice Address - Country:US
Practice Address - Phone:314-464-3979
Practice Address - Fax:314-464-4288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Single Specialty