Provider Demographics
NPI:1194811406
Name:CARDIOLOGY SPECIALISTS PC
Entity type:Organization
Organization Name:CARDIOLOGY SPECIALISTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PATIENT ACCOUNTS SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:PARR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-447-1301
Mailing Address - Street 1:3023 N BALLAS RD
Mailing Address - Street 2:SUITE 400D
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63131-2330
Mailing Address - Country:US
Mailing Address - Phone:314-447-1301
Mailing Address - Fax:314-447-1310
Practice Address - Street 1:3023 N BALLAS RD
Practice Address - Street 2:SUITE 400D
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-2330
Practice Address - Country:US
Practice Address - Phone:314-447-1301
Practice Address - Fax:314-447-1310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2009-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILCH7117OtherRAILROAD MEDICARE
MOCP9092OtherRAILROAD MEDICARE
MOCP9092OtherRAILROAD MEDICARE
ILCH7117OtherRAILROAD MEDICARE