Provider Demographics
NPI:1831599059
Name:SOUTH COUNTY WOMEN'S HEALTH, P.C.
Entity type:Organization
Organization Name:SOUTH COUNTY WOMEN'S HEALTH, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHNAPP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-270-8051
Mailing Address - Street 1:PO BOX 1645
Mailing Address - Street 2:
Mailing Address - City:FENTON
Mailing Address - State:MO
Mailing Address - Zip Code:63026-1645
Mailing Address - Country:US
Mailing Address - Phone:314-432-2580
Mailing Address - Fax:314-432-0223
Practice Address - Street 1:12345 W BEND DR
Practice Address - Street 2:105
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-2182
Practice Address - Country:US
Practice Address - Phone:314-270-8051
Practice Address - Fax:314-270-9561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-25
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MODV2881OtherRAILROAD MEDICARE GROUP PTAN
MO1831599059Medicaid
MO1831599059Medicaid