South County Eye Care

LBN: South County Eye Care
South County Eye Care is an health care organization with primary practice located at 13131 Tesson Ferrry Rd #108 , St Louis MO 63128. The organization recently has only one registered license in Managed Care Organizations / Preferred Provider Organization, which is considered as the primary health care specialty. South County Eye Care can be contacted via phone (314) 843-5800, or through Polk, Brandi Nicole via phone (314) 843-5800.

Contact Information

Primary practice address
13131 Tesson Ferrry Rd #108 St Louis MO 63128
Phone: (314) 843-5800
Fax: (314) 843-5290
Website:
Map and Directions
Authorized official contact:
Name: Polk, Brandi Nicole
Phone: (314) 843-5800

Health care specialties

SpecialtyCodeLicense #State
Managed Care Organizations / Preferred Provider Organization 305R00000X MDR9N88 Missouri

Profile Details

NPI number 1801981899
LBN Legal business name South County Eye Care
DBA Doing business as South County Eye Care
Authorized official Polk, Brandi Nicole
Entity Organization
Organization subpart 1 No
Enumeration date Oct 4th, 2006
Last updated Feb 19th, 2019 - 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 1801981899 NPPES
Missouri MEDICAID 203015219
Missouri Other MDR9N88

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