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Organization
SAINT LOUIS UNIVERSITY
Active
Organization
SAINT LOUIS UNIVERSITY
Active
Parent organization
SAINT LOUIS UNIVERSITY
Other names
SLUCare
Organization subpart
Yes
Provider details
NPI number
Legal business name
SAINT LOUIS UNIVERSITY
Authorized official
FRED BUCKHOLD III M.D. (PROGRAM DIRECTOR)
(314) 577-8762
Entity
Organization
Contact information
Practice address
3660 VISTA AVE, SAINT LOUIS, MO 63110-2540
(314) 977-6100
Mailing address
1402 S GRAND BLVD, SAINT LOUIS, MO 63104-1004
(314) 577-8762
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
NULL
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/21/2017
Last updated
03/21/2017
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