| NPI | 1225458953 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA C. BENTRUP Chief Financial Officer 314-656-2720 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Enumeration Date | 2014-04-21 |
| Last Update Date | 2014-04-22 |