Organization
BETTY JEAN KERR PEOPLE'S HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HEWART TILLETT CFO (CHIEF FINANCIAL OFFICER)
(314) 367-7848
Entity
Organization
Contact information
Practice address
5701 DELMAR BLVD, SAINT LOUIS, MO 63112-2617
(314) 367-7848
(314) 367-2985
Mailing address
5701 DELMAR BLVD, SAINT LOUIS, MO 63112-2617
(314) 367-7848
(314) 367-2985
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
072100
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010545
MEDICARE PART B UPIN
MO
Enumeration date
03/06/2013
Last updated
03/06/2013
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