Fairview Heights Medical Group Sc
LBN: Fairview Heights Medical Group Sc
Fairview Heights Medical Group Sc is an health care organization with primary practice located at 670 Mason Ridge Center Dr Suite 300, Saint Louis MO 63141-8573. The organization recently has 3 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Multi-Specialty, Ambulatory Health Care Facilities / Medical Specialty, Ambulatory Health Care Facilities / Primary Care. Ambulatory Health Care Facilities / Multi-Specialty is the primary health care specialty.
Fairview Heights Medical Group Sc can be contacted via phone (314) 996-7644, or through Canter-Koester, Karen via phone (314) 996-7610.
Contact Information
Primary practice address
670 Mason Ridge Center Dr Suite 300
Saint Louis MO 63141-8573
Phone: (314) 996-7644
Fax: (314) 996-7658
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Multi-Specialty | 261QM1300X | ||
| Ambulatory Health Care Facilities / Medical Specialty | 261QM2500X | ||
| Ambulatory Health Care Facilities / Primary Care | 261QP2300X |
Profile Details
| NPI number | 1679503668 |
|---|---|
| LBN Legal business name | Fairview Heights Medical Group Sc |
| DBA Doing business as | |
| Authorized official | Canter-Koester, Karen |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 4th, 2006 |
| Last updated | Jul 16th, 2020 - about 4 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1679503668 | NPPES |
| Missouri | MEDICAID | 500720107 |
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