Organization
SSM CARDINAL GLENNON CHILDRENS HOSPITAL
Active
Parent organization
SSM CARDINAL GLENNON CHILDREN'S HOSPITAL
Other names
SSM Health Cardinal Glennon Pediatrics
Organization subpart
Yes
Provider details
NPI number
Legal business name
SSM CARDINAL GLENNON CHILDREN'S HOSPITAL
Authorized official
MRS. KAREN REWERTS CFO (SYSTEM VICE PRESIDENT FINANCE)
(314) 989-6843
Entity
Organization
Contact information
Practice address
2927 S . KINGS HIGHWAY BLVD, SAINT LOUIS, MO 63139-1008
(314) 268-4070
(314) 268-4019
Mailing address
1173 CORPORATE LAKE DR, SAINT LOUIS, MO 63132-1716
(314) 989-6843
(314) 344-7239
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26D2159157
CLIA
—
05
—
505459107
—
MO
05
—
540155801
—
MO
Enumeration date
05/24/2006
Last updated
11/18/2022
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