Sureguard Llc | |
10007 Kennerly Rd Ste B Saint Louis MO 63128-2179 | |
(866) 280-1543 | |
Not Available |
Full Name | Sureguard Llc |
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Speciality | Internal Medicine |
Location | 10007 Kennerly Rd Ste B, Saint Louis, Missouri |
Authorized Official Name and Position | Lee Brochstein (EXECUTIVE DIRECTOR OF CORPORATE OPS) |
Authorized Official Contact | 7137038642 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Sureguard Llc 5307 Jason St Houston TX 77096-1232 Ph: () - | Sureguard Llc 10007 Kennerly Rd Ste B Saint Louis MO 63128-2179 Ph: (866) 280-1543 |
NPI Number | 1538917026 |
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Provider Enumeration Date | 05/09/2024 |
Last Update Date | 12/23/2024 |
Medicare PECOS PAC ID | 6709241763 |
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Medicare Enrollment ID | O20240607000942 |
Identifier | Type | State | Issuer |
---|---|---|---|
1538917026 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
261QA1903X | Clinic/center - Ambulatory Surgical | (* (Not Available)) | Secondary |
Provider Name | Paul S Catanzaro |
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Provider Type | Practitioner - Interventional Pain Management |
Provider Identifiers | NPI Number: 1386653731 PECOS PAC ID: 6800858770 Enrollment ID: I20041102000992 |
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