Provider Demographics
NPI:1316175417
Name:URGENT CARE CENTERS OF ST. ANTHONY'S MEDICAL CENTER, LC
Entity type:Organization
Organization Name:URGENT CARE CENTERS OF ST. ANTHONY'S MEDICAL CENTER, LC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CMO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:MORTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-525-1000
Mailing Address - Street 1:10010 KENNERLY RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63128-2106
Mailing Address - Country:US
Mailing Address - Phone:314-525-1000
Mailing Address - Fax:
Practice Address - Street 1:3619 RICHARDSON SQUARE DR
Practice Address - Street 2:
Practice Address - City:ARNOLD
Practice Address - State:MO
Practice Address - Zip Code:63010-6022
Practice Address - Country:US
Practice Address - Phone:636-717-6700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST. ANTHONY'S MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-06-26
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO273-34282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital