Provider Demographics
NPI:1770544066
Name:ARTHRITIS CONSULTANTS INC.
Entity type:Organization
Organization Name:ARTHRITIS CONSULTANTS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-567-5100
Mailing Address - Street 1:522 N NEW BALLAS RD STE 240
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-6819
Mailing Address - Country:US
Mailing Address - Phone:314-567-5100
Mailing Address - Fax:314-567-3387
Practice Address - Street 1:522 N NEW BALLAS RD STE 240
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141
Practice Address - Country:US
Practice Address - Phone:314-567-5100
Practice Address - Fax:314-567-3387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-28
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
No332900000XSuppliersNon-Pharmacy Dispensing SiteGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO501611107Medicaid
MO=========OtherGREAT WEST
MO501611107Medicaid
MO=========OtherHEALTHLINK
MO=========OtherBLUE CROSS BLUE SHIELD
MO=========OtherAETNA
MO=========OtherPHCS
MO=========OtherMERCY