# SSM CARDINAL GLENNON CHILDRENS HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SSM HEALTHCARE ST. LOUIS
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1609969880
- **Legal business name:** SSM HEALTHCARE ST. LOUIS
- **Authorized official:** KIMBERLY SPENCER (V.P. PHARMACY SERVICES)
- **Authorized official phone:** (314) 989-2588

## Contact information

- **Practice address:** 1465 S GRAND BLVD, SAINT LOUIS, MO 63104-1003
- **Practice address phone:** (314) 577-5683
- **Practice address fax:** (314) 268-4069
- **Mailing address:** 1465 S GRAND BLVD, SAINT LOUIS, MO 63104-1003

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | 006069 | MO | Yes |
| 3336C0002X | Clinic Pharmacy | — | — | — |
| 3336C0003X | Community/Retail Pharmacy | — | — | — |

## Other

- **Enumeration date:** 10/02/2006
- **Last updated:** 10/18/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2614217 | OTHER ID NUMBER-COMMERCIAL NUMBER | — |
| 05 | — | 430718920003 | — | IL |
| 05 | — | 600155808 | — | MO |