Organization
WASHINGTON UNIVERSITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CATHY EGHIGIAN (SENIOR DIRECTOR MANAGED CARE)
(314) 273-0770
Entity
Organization
Contact information
Practice address
4901 FOREST PARK AVE, SAINT LOUIS, MO 63108
(314) 362-3937
(314) 362-3725
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 273-0770
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0062375
SPECIAL HEALTH CARE NEEDS
MO
01
—
08-01999
UHC GROUP NUMBER
MO
01
—
108RP6
BLUE SHIELD BILLING CODE
MO
01
—
3697
GHP MASTER VENDOR
MO
05
—
552919508
—
MO
01
—
610916400
DEPARTMENT OF LABOR
MO
01
—
673341
AETNA HMO GROUP
MO
01
—
92215217
BLUE SHIELD GROUP
IL
Enumeration date
06/06/2006
Last updated
04/25/2025
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