Organization
WASHINGTON UNIVERSITY
Active
Other names
Forest Park Kidney Center
Organization subpart
No
Provider details
NPI number
Authorized official
CATHY EGHIGIAN (DIRECTOR, CREDENTIALING OPERATIONS)
(314) 273-0770
Entity
Organization
Contact information
Practice address
4205 FOREST PARK AVE, SAINT LOUIS, MO 63108-2810
(314) 286-0842
Mailing address
4240 DUNCAN AVE, CAMPUS BOX 8221, SAINT LOUIS, MO 63110-1123
(314) 273-0770
(314) 273-0470
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500724208
—
MO
Enumeration date
06/29/2006
Last updated
12/30/2015
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