Provider Demographics
NPI:1790849321
Name:ST CHARLESCODEPT OF COMMHEALTH & THE ENV
Entity Type:Organization
Organization Name:ST CHARLESCODEPT OF COMMHEALTH & THE ENV
Other - Org Name:ST CHARLES HEALTH DEPT
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GIL
Authorized Official - Middle Name:
Authorized Official - Last Name:COPLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:636-949-7477
Mailing Address - Street 1:1650 BOONES LICK RD
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63301-2245
Mailing Address - Country:US
Mailing Address - Phone:636-949-7400
Mailing Address - Fax:636-949-7403
Practice Address - Street 1:1650 BOONES LICK RD
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63301-2245
Practice Address - Country:US
Practice Address - Phone:636-949-7400
Practice Address - Fax:636-949-7403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare