| Southampton Community Healthcare Inc | |
|
2340 Hampton Ave Saint Louis MO 63139-2935 | |
| (314) 647-2200 | |
| (314) 647-4172 |
| Full Name | Southampton Community Healthcare Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2340 Hampton Ave, Saint Louis, Missouri |
| Authorized Official Name and Position | Matthew Marshall (OFFICE MANAGER) |
| Authorized Official Contact | 3146472200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southampton Community Healthcare Inc 2340 Hampton Ave Saint Louis MO 63139-2935 Ph: (314) 647-2200 | Southampton Community Healthcare Inc 2340 Hampton Ave Saint Louis MO 63139-2935 Ph: (314) 647-2200 |
| NPI Number | 1013677293 |
|---|---|
| Provider Enumeration Date | 12/29/2021 |
| Last Update Date | 06/11/2024 |
| Medicare PECOS PAC ID | 5799218814 |
|---|---|
| Medicare Enrollment ID | O20241029000936 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013677293 | NPI | - | NPPES |
| Provider Name | David J Prelutsky |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457354276 PECOS PAC ID: 2163523200 Enrollment ID: I20100510000011 |
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