NPIMap

Organization Active NPI

SSM Health Care St Louis

Doing business as SSM Health Pharmacy

  • Community/Retail Pharmacy
  • Bridgeton, MO
National Provider Identifier
1003058371
Registry record updated Oct 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
SSM HEALTH CARE ST LOUIS
Doing business as
SSM Health Pharmacy
Practice address
12266 Depaul Dr. Suite 105
Bridgeton, MO 63044
Phone
(314) 344-7300
Fax
(314) 344-6179
NPI assigned
Apr 1, 2009
Last updated
Oct 18, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kimberly Spencer, PHARMD
Title
V.P. Pharmacy Services
Phone
(314) 989-2588

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X 2009004862 MO
Community/Retail Pharmacy 3336C0003X NU Primary

Addresses

Primary practice location

12266 Depaul Dr. Suite 105
Bridgeton, MO 63044

Mailing address

12266 Depaul Dr. Suite 105
Bridgeton, MO 63044
Phone (314) 344-7300

Other identifiers 2

IdentifierTypeStateIssuer
606172302MedicaidMO
2119641OtherPK

Other names 1

  • SSM Health Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230509001911 MO Part B Supplier - Pharmacy 7810800737 4 other NPIs on this enrollment
Practice locations: Wentzville, MO; Saint Louis, MO; Saint Charles, MO; Bridgeton, MO

Other NPIs with the same Medicare PAC ID 13

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 13

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

12312 Olive Blvd
Ste 500
Saint Louis, MO 63141

Ownership & related parties

All facility ownership & control disclosures 11

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
SSM Health St. Clare Hospital - FentonFenton, MO, CCN 260081 Hospital 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2015
SSM Health Rehabilitation HospitalRichmond Heights, MO, CCN 263031 Hospital 5% Or Greater Direct Ownership Interest (49%) May 1, 2009
SSM Health Saint Louis University HospitalSaint Louis, MO, CCN 260105 Hospital 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2015
SSM Health Saint Louis University HospitalSaint Louis, MO, CCN 26S105 Hospital 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2015
SSM Health St Joseph Hospital - Lake Saint LouisLake Saint Louis, MO, CCN 260200 Hospital 5% Or Greater Direct Ownership Interest (100%) Sep 17, 2014
SSM Health St Joseph Hospital - St CharlesSaint Charles, MO, CCN 260005 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Sep 11, 1984
Oct 12, 2015
SSM Health St. Mary's Hospital - St. LouisSaint Louis, MO, CCN 26S091 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 13, 2014
SSM Health St. Mary's Hospital - St LouisSaint Louis, MO, CCN 260091 Hospital 5% Or Greater Direct Ownership Interest (100%) Sep 11, 1984
SSM Health Depaul Hospital St LouisBridgeton, MO, CCN 26S104 Hospital 5% Or Greater Direct Ownership Interest (100%) Dec 16, 2013
SSM Health Depaul Hospital - St LouisBridgeton, MO, CCN 260104 Hospital 5% Or Greater Direct Ownership Interest (100%) Oct 10, 2014
SSM Health Depaul Hospital - Anna HouseBridgeton, MO, CCN 265842 Skilled nursing facility 5% Or Greater Indirect Ownership Interest (100%) Sep 1, 2015

Owned or controlled facilities with NPI records 12

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • SSM Health Care St. Louis

    dba SSM Health DePaul Hospital - St. Louis

    • Psychiatric Hospital Unit
    • Bridgeton, MO
    • NPI 1053481861

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • SSM Health Care St. Louis

    dba SSM Health Cardinal Glennon Children's Hospital

    • General Acute Care Hospital
    • Saint Louis, MO
    • NPI 1336387836

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • SSM Health Care St. Louis

    dba SSM Health DePaul Hospital - Anna House

    • Skilled Nursing Facility
    • Bridgeton, MO
    • NPI 1346237112

    5% Or Greater Indirect Ownership Interest

    CMS ownership
  • SSM Health Care St. Louis

    dba SSM Health St. Joseph Hospital - St. Charles

    • General Acute Care Hospital
    • Saint Charles, MO
    • NPI 1467521146

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • SSM Health Care St. Louis

    dba SSM Health DePaul Hospital - St. Louis

    • General Acute Care Hospital
    • Bridgeton, MO
    • NPI 1598835308

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • SSM Health Care St. Louis

    dba SSM Health St. Mary's Hospital - St. Louis

    • Psychiatric Hospital Unit
    • Saint Louis, MO
    • NPI 1780763284

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • SSM Health Care St. Louis

    dba SSM Health St. Clare Hospital - Fenton

    • General Acute Care Hospital
    • Fenton, MO
    • NPI 1851496152

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • SSM Health Care St. Louis

    dba SSM Health St Joseph Hospital - Lake Saint Louis

    • General Acute Care Hospital
    • Lake St Louis, MO
    • NPI 1871665380

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • SSM Health Care St. Louis

    dba SSM Health St. Mary's Hospital - St. Louis

    • General Acute Care Hospital
    • Saint Louis, MO
    • NPI 1962572396

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • SSM Select Rehab St Louis LLC
    • Rehabilitation Hospital
    • Richmond Heights, MO
    • NPI 1659511988

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • SSM-Sluh Inc

    dba SSM Health Saint Louis University Hospital

    • Psychiatric Hospital Unit
    • Saint Louis, MO
    • NPI 1528443702

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • SSM-Sluh Inc

    dba SSM Health Saint Louis University Hospital

    • General Acute Care Hospital
    • Saint Louis, MO
    • NPI 1942685920

    5% Or Greater Direct Ownership Interest

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1238544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666051200000",
    "number": "1003058371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12266 DEPAUL DR. SUITE 105",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "63044",
            "telephone_number": "314-344-7300",
            "fax_number": "314-344-6179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12266 DEPAUL DR. SUITE 105",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "63044",
            "telephone_number": "314-344-7300",
            "fax_number": "314-344-6179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SSM HEALTH CARE ST LOUIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-01",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A",
        "authorized_official_last_name": "SPENCER",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "V.P. PHARMACY SERVICES",
        "authorized_official_telephone_number": "314-989-2588",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MO",
            "license": "2009004862",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "606172302",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2119641",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SSM Health Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SSM Health Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bridgeton, MO

Sources for this page

Verify at the official NPI Registry.