Provider Demographics
NPI:1740601145
Name:PLANNED PARENTHOOD OF THE ST. LOUIS REGION AND SOUTHWEST MISSOURI
Entity Type:Organization
Organization Name:PLANNED PARENTHOOD OF THE ST. LOUIS REGION AND SOUTHWEST MISSOURI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-828-1804
Mailing Address - Street 1:4251 FOREST PARK AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63108-2810
Mailing Address - Country:US
Mailing Address - Phone:314-531-7526
Mailing Address - Fax:314-531-3190
Practice Address - Street 1:1 STONEGATE CTR
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:MO
Practice Address - Zip Code:63088-1215
Practice Address - Country:US
Practice Address - Phone:636-431-0030
Practice Address - Fax:636-431-0035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-02
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO520524240Medicaid