Organization
ALLEGIANCE MEDICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TONY BRUCE CAMILLO (MANAGING PARTNER)
(314) 646-8234
Entity
Organization
Contact information
Practice address
2331 HAMPTON AVE, LOWER LEVEL, SAINT LOUIS, MO 63139-2908
(314) 646-8234
(314) 646-8349
Mailing address
2331 HAMPTON AVE, LOWER LEVEL, SAINT LOUIS, MO 63139-2908
(314) 646-8234
(314) 646-8349
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023342391
—
MO
Enumeration date
09/19/2009
Last updated
05/18/2012
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