Forest Park Dialysis Clinic

LBN: Nra-St. Louis, Missouri, Llc
Forest Park Dialysis Clinic is an health care organization with primary practice located at 2635 Hampton Ave , Saint Louis MO 63139-2912. The organization recently has only one registered license in Ambulatory Health Care Facilities / End-Stage Renal Disease (ESRD) Treatment, which is considered as the primary health care specialty. Nra-St. Louis, Missouri, Llc can be contacted via phone (314) 646-1717, or through Blanton, Barry L. via phone (781) 699-9000.

Contact Information

Primary practice address
2635 Hampton Ave Saint Louis MO 63139-2912
Phone: (314) 646-1717
Fax: (314) 646-0636
Website:
Map and Directions
Authorized official contact:
Name: Blanton, Barry L.
Phone: (781) 699-9000

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / End-Stage Renal Disease (ESRD) Treatment 261QE0700X N/A Missouri

Profile Details

NPI number 1548201874
LBN Legal business name Nra-St. Louis, Missouri, Llc
DBA Doing business as Forest Park Dialysis Clinic
Authorized official Blanton, Barry L.
Entity Organization
Organization subpart 1 Yes
Enumeration date Jun 9th, 2006
Last updated Oct 17th, 2023 - about 3 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 1548201874 NPPES
Missouri MEDICAID 506954502
Missouri Other 26D1053303

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