Provider Demographics
NPI:1982740528
Name:SIGNATURE HEALTHCARE FOUNDATION
Entity Type:Organization
Organization Name:SIGNATURE HEALTHCARE FOUNDATION
Other - Org Name:SIGNATURE FOUNDATION REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:R
Authorized Official - Last Name:EARNHART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-416-0439
Mailing Address - Street 1:4850 LEMAY FERRY RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63129-1576
Mailing Address - Country:US
Mailing Address - Phone:314-416-0439
Mailing Address - Fax:314-487-3062
Practice Address - Street 1:4850 LEMAY FERRY RD
Practice Address - Street 2:SUITE 120
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63129-1576
Practice Address - Country:US
Practice Address - Phone:314-416-0439
Practice Address - Fax:314-416-7184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies