Organization
PEDIATRIX MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUZANNE HENTRICH (HOSPITAL ASSOCIATE)
(314) 251-5860
Entity
Organization
Contact information
Practice address
615 S NEW BALLAS RD, NEONATAL INTENSIVE CARE UNIT, SAINT LOUIS, MO 63141-8221
(314) 251-6450
Mailing address
621 S NEW BALLAS RD, SUITE # 2016B, SAINT LOUIS, MO 63141-8232
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
2012029888
MO
Other
Enumeration date
09/26/2012
Last updated
09/26/2012
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