Provider Demographics
NPI:1205884582
Name:GOAL ORIENTED HEALTHCARE, INC
Entity type:Organization
Organization Name:GOAL ORIENTED HEALTHCARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:ONEILL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-653-8600
Mailing Address - Street 1:11155 DUNN RD
Mailing Address - Street 2:SUITE 202E
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63136-6150
Mailing Address - Country:US
Mailing Address - Phone:314-653-8600
Mailing Address - Fax:314-653-6950
Practice Address - Street 1:11155 DUNN RD
Practice Address - Street 2:SUITE 202E
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63136-6150
Practice Address - Country:US
Practice Address - Phone:314-653-8600
Practice Address - Fax:314-653-6950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-05
Last Update Date:2015-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003023545207R00000X
MO2003026273207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO207628009Medicaid
MO209203603Medicaid
MO209203603Medicaid