South Towne Square Dialysis Clinic

LBN: Nra-South City, Missouri, Llc
South Towne Square Dialysis Clinic is an health care organization with primary practice located at 11107 S Towne Sq , Saint Louis MO 63123-7814. The organization recently has only one registered license in Ambulatory Health Care Facilities / End-Stage Renal Disease (ESRD) Treatment, which is considered as the primary health care specialty. Nra-South City, Missouri, Llc can be contacted via phone (314) 894-3400, or through Blanton, Barry L. via phone (781) 699-9000.

Contact Information

Primary practice address
11107 S Towne Sq Saint Louis MO 63123-7814
Phone: (314) 894-3400
Fax: (314) 894-1384
Website:
Map and Directions
Authorized official contact:
Name: Blanton, Barry L.
Phone: (781) 699-9000

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / End-Stage Renal Disease (ESRD) Treatment 261QE0700X N/A Missouri

Profile Details

NPI number 1225079395
LBN Legal business name Nra-South City, Missouri, Llc
DBA Doing business as South Towne Square Dialysis Clinic
Authorized official Blanton, Barry L.
Entity Organization
Organization subpart 1 Yes
Enumeration date Jun 9th, 2006
Last updated Oct 17th, 2023 - about last year

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225079395 NPPES
Missouri Other 26D1053597 CLIA CERTIFICATE OF WAIVE
Missouri MEDICAID 506960806 CLIA CERTIFICATE OF WAIVE

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