Organization
SSM CARDINAL GLENNON CHILDREN'S MEDICAL CENTER
Active
Parent organization
SSM HEALTHCARE
Organization subpart
Yes
Provider details
NPI number
Legal business name
SSM HEALTHCARE
Authorized official
M CHRISTINE GREEN APRN (TRAUMA PROGRAM MANAGER)
(314) 577-5392
Entity
Organization
Contact information
Practice address
1465 S GRAND BLVD, SAINT LOUIS, MO 63104-1003
(314) 577-5600
(314) 268-6441
Mailing address
1465 S GRAND BLVD, SAINT LOUIS, MO 63104-1003
(314) 577-5600
(314) 268-6441
Taxonomy
Speciality
Code
Description
License number
State
282NC2000X
Children's Hospital
Primary
363L00000X
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
079924
STATE APRN LICENSE
MO
Enumeration date
09/16/2009
Last updated
09/16/2009
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