| Southampton Healthcare Inc | |
|
2340 Hampton Ave Saint Louis MO 63139-2909 | |
| (314) 647-2200 | |
| Not Available |
| Full Name | Southampton Healthcare Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2340 Hampton Ave, Saint Louis, Missouri |
| Authorized Official Name and Position | David Prelutsky (MEDICAL DIRECTOR) |
| Authorized Official Contact | 3146472200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southampton Healthcare Inc Po Box 952024 Saint Louis MO 63195-2024 Ph: (314) 647-2200 | Southampton Healthcare Inc 2340 Hampton Ave Saint Louis MO 63139-2909 Ph: (314) 647-2200 |
| NPI Number | 1982756771 |
|---|---|
| Provider Enumeration Date | 01/18/2007 |
| Last Update Date | 01/23/2008 |
| Medicare PECOS PAC ID | 5193826238 |
|---|---|
| Medicare Enrollment ID | O20070719000576 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982756771 | NPI | - | NPPES |
| CH6460 | Other | MO | RR MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
| Provider Name | David J Prelutsky |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457354276 PECOS PAC ID: 2163523200 Enrollment ID: I20100510000011 |
| Provider Name | Tassy Hayden |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871889303 PECOS PAC ID: 8022249192 Enrollment ID: I20141006000503 |
| Provider Name | Michael F Donovan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669852448 PECOS PAC ID: 8426351974 Enrollment ID: I20180625000789 |
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