Provider Demographics
NPI:1942661186
Name:ST LOUIS SOCIETY FOR THE BLIND
Entity Type:Organization
Organization Name:ST LOUIS SOCIETY FOR THE BLIND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:C
Authorized Official - Last Name:EKIN
Authorized Official - Suffix:
Authorized Official - Credentials:ACSW
Authorized Official - Phone:314-968-9000
Mailing Address - Street 1:8770 MANCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63144-2724
Mailing Address - Country:US
Mailing Address - Phone:314-968-9000
Mailing Address - Fax:314-968-9003
Practice Address - Street 1:8770 MANCHESTER RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63144-2724
Practice Address - Country:US
Practice Address - Phone:314-968-9000
Practice Address - Fax:314-968-9003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-16
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WL0500XEye and Vision Services ProvidersOptometristLow Vision RehabilitationGroup - Single Specialty