Provider Demographics
NPI:1285609966
Name:SSM HEALTH BUSINESSES
Entity type:Organization
Organization Name:SSM HEALTH BUSINESSES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT PATIENT CARE SERVICE
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWEITZER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:608-778-2146
Mailing Address - Street 1:600 MEDICAL DR STE 209
Mailing Address - Street 2:
Mailing Address - City:WENTZVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63385-3426
Mailing Address - Country:US
Mailing Address - Phone:636-695-2050
Mailing Address - Fax:636-695-2060
Practice Address - Street 1:600 MEDICAL DR STE 209
Practice Address - Street 2:
Practice Address - City:WENTZVILLE
Practice Address - State:MO
Practice Address - Zip Code:63385-3426
Practice Address - Country:US
Practice Address - Phone:636-695-2050
Practice Address - Fax:636-695-2060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-17
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO105-11HO251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO822756102Medicaid
MO261515AMedicare Oscar/Certification