Provident

LBN: Provident
Provident is an health care organization with primary practice located at 3675 W Outer Rd 203, Arnold MO 63010-5232. The organization recently has 2 registered licenses in different health care specialties including Agencies / Hospice Care, Community Based, Managed Care Organizations / Preferred Provider Organization. Agencies / Hospice Care, Community Based is the primary health care specialty. Provident can be contacted via phone (314) 898-0102, or through Bulin, Kristin via phone (314) 371-6500.

Contact Information

Primary practice address
3675 W Outer Rd 203 Arnold MO 63010-5232
Phone: (314) 898-0102
Fax: (636) 296-3249
Website:
Map and Directions
Authorized official contact:
Name: Bulin, Kristin MSW
Phone: (314) 371-6500

Health care specialties

SpecialtyCodeLicense #State
Agencies / Hospice Care, Community Based 251G00000X 002589 Missouri
Managed Care Organizations / Preferred Provider Organization 305R00000X SW002589 Missouri

Profile Details

NPI number 1316005473
LBN Legal business name Provident
DBA Doing business as
Authorized official Bulin, Kristin MSW
Entity Organization
Organization subpart 1 No
Enumeration date Dec 4th, 2006
Last updated Aug 22nd, 2020 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316005473 NPPES
Missouri MEDICAID 496768326

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