| Mbs Advantage Inc | |
|
11618 Gravois Rd Saint Louis MO 63126-3014 | |
| (314) 842-1900 | |
| (314) 842-9185 |
| Full Name | Mbs Advantage Inc |
|---|---|
| Speciality | General Practice |
| Location | 11618 Gravois Rd, Saint Louis, Missouri |
| Authorized Official Name and Position | Jean L Foster (PRESIDENT) |
| Authorized Official Contact | 3148421900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mbs Advantage Inc 11618 Gravois Rd Saint Louis MO 63126-3014 Ph: (314) 842-1900 | Mbs Advantage Inc 11618 Gravois Rd Saint Louis MO 63126-3014 Ph: (314) 842-1900 |
| NPI Number | 1083612253 |
|---|---|
| Provider Enumeration Date | 07/12/2005 |
| Last Update Date | 03/11/2012 |
| Medicare PECOS PAC ID | 5799671103 |
|---|---|
| Medicare Enrollment ID | O20040224000275 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083612253 | NPI | - | NPPES |
| 500893409 | Medicaid | MO | |
| 121947 | Other | BCBS | |
| 271325663 | Medicaid | IL |
| Provider Name | Caroline Shieh |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1740257559 PECOS PAC ID: 2466847306 Enrollment ID: I20220311001363 |
| Provider Name | John A Stith |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1164449757 PECOS PAC ID: 2264598903 Enrollment ID: I20220721002972 |
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