Provider Demographics
NPI:1871865881
Name:NORTH COUNTY HEALTH CARE, INC
Entity Type:Organization
Organization Name:NORTH COUNTY HEALTH CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ADELUOLA
Authorized Official - Middle Name:G
Authorized Official - Last Name:LIPEDE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-522-1888
Mailing Address - Street 1:9231 WEST FLORISSANT
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63136-1432
Mailing Address - Country:US
Mailing Address - Phone:314-522-1888
Mailing Address - Fax:314-522-9674
Practice Address - Street 1:9231 WEST FLORISSANT
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63136-1432
Practice Address - Country:US
Practice Address - Phone:314-522-1888
Practice Address - Fax:314-522-9674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-07
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR7F89261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center