Organization
ALTA PREMIER HEALTH SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALPHONSE BEAUBOEUF M.D. (PRESIDENT/PHYSICIAN)
(314) 361-0477
Entity
Organization
Contact information
Practice address
625 NORTH EUCLID AVENUE, SUITE 214, SAINT LOUIS, MO 63113-1660
(314) 361-0477
(314) 361-3771
Mailing address
625 NORTH EUCLID AVENUE, SUITE 214, SAINT LOUIS, MO 63108-1660
(314) 361-0477
(314) 361-3771
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
507381309
—
MO
Enumeration date
08/27/2007
Last updated
05/02/2012
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