Missouri Heart Care, LLC
Clinic/Center in Kirkwood, MO. Organization (NPI-2).
NPI number1417060880
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1417060880
- Entity type
- Organization (NPI-2)
- Legal business name
- Missouri Heart Care, LLC
- Organization subpart
- No
- Enumeration date
- Aug 17, 2006
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | – | – | Yes |
Practice location
525 Couch AveSuite 400
Kirkwood, MO 63122-5536
Phone 314-984-8860
Mailing address
525 Couch AveSuite 400
Kirkwood, MO 63122-5536
Phone 314-984-8860
Authorized official
Jerome Valentine Dwyer
Chief Executive Officer
3149848860
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