Organization
DEPARTMENT OF VETERANS AFFAIRS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ASIFA SUFI (CHIEF PMRS)
(314) 652-4100
Entity
Organization
Contact information
Practice address
915 N GRAND BLVD, SAINT LOUIS, MO 63106-1621
(314) 652-4100
(314) 845-5077
Mailing address
915 N GRAND BLVD, SAINT LOUIS, MO 63106-1621
Taxonomy
Speciality
Code
Description
License number
State
273Y00000X
Rehabilitation Hospital Unit
Primary
2003011966
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1033180526
1467789222
MO
Enumeration date
05/04/2015
Last updated
05/04/2015
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