| Mercy Jfk Clinic | |
|
621 S New Ballas Rd Saint Louis MO 63141-8232 | |
| (314) 251-6382 | |
| (314) 251-4454 |
| Full Name | Mercy Jfk Clinic |
|---|---|
| Speciality | Clinic/center |
| Location | 621 S New Ballas Rd, Saint Louis, Missouri |
| Authorized Official Name and Position | Jeffrey A. Johnston (PRESIDENT) |
| Authorized Official Contact | 3142516000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mercy Jfk Clinic 621 S New Ballas Rd Saint Louis MO 63141-8232 Ph: (314) 251-6382 | Mercy Jfk Clinic 621 S New Ballas Rd Saint Louis MO 63141-8232 Ph: (314) 251-6382 |
| NPI Number | 1265572812 |
|---|---|
| Provider Enumeration Date | 02/06/2007 |
| Last Update Date | 04/30/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265572812 | NPI | - | NPPES |
| 505812800 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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