Provider Demographics
NPI:1194765685
Name:WASHINGTON UNIVERSITY
Entity type:Organization
Organization Name:WASHINGTON UNIVERSITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR DIRECTOR, MANAGED CARE
Authorized Official - Prefix:MS
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:L
Authorized Official - Last Name:EGHIGIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-273-0770
Mailing Address - Street 1:660 SOUTH EUCLID AVENUE
Mailing Address - Street 2:CAMPUS BOX 8515
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63105-2171
Mailing Address - Country:US
Mailing Address - Phone:314-273-0770
Mailing Address - Fax:314-273-0470
Practice Address - Street 1:1 CHILDRENS PL
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1002
Practice Address - Country:US
Practice Address - Phone:314-286-1264
Practice Address - Fax:314-286-1258
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-07
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO673341OtherAETNA HMO GROUP
IL92215224OtherBLUE SHIELD
MO3775OtherGHP MASTER VENDOR
MO4DP71OtherBLUE SHIELD
MO552927600OtherMEDICAID PHARMACY
MO552927600Medicaid
MO610916400OtherDEPARTMENT OF LABOR
MO75-02999OtherUHC GROUP
MO4DP71OtherBLUE SHIELD
IL205476Medicare PIN
MOCC6129Medicare PIN
MO75-02999OtherUHC GROUP
MO000010381Medicare PIN