| Ssm Health St. Mary's Hospital - St. Louis | |
|
6420 Clayton Rd Saint Louis MO 63117-1811 | |
| (314) 768-8000 | |
| (314) 768-8011 |
| Full Name | Ssm Health St. Mary's Hospital - St. Louis |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 6420 Clayton Rd, Saint Louis, Missouri |
| Authorized Official Name and Position | Travis Capers (PRESIDENT) |
| Authorized Official Contact | 3147688052 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ssm Health St. Mary's Hospital - St. Louis 6420 Clayton Rd Saint Louis MO 63117-1811 Ph: (314) 768-8000 | Ssm Health St. Mary's Hospital - St. Louis 6420 Clayton Rd Saint Louis MO 63117-1811 Ph: (314) 768-8000 |
| NPI Number | 1780763284 |
|---|---|
| Provider Enumeration Date | 11/03/2006 |
| Last Update Date | 11/27/2023 |
| Medicare PECOS PAC ID | 7810800737 |
|---|---|
| Medicare Enrollment ID | O20160209000319 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780763284 | NPI | - | NPPES |
| 010326205 | Medicaid | MO | |
| 540326204 | Medicaid | MO | |
| 43065268100 | Medicaid | IL | |
| 43065268140 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 383-13 (Missouri) | Primary |
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