Allegiance Medical Services

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

ALLEGIANCE MEDICAL SERVICES

Practice address

2331 Hampton Ave
Lower Level
Saint Louis, MO 63139-2908

Phone

(314) 646-8234

Fax

(314) 646-8349

NPI assigned

Sep 19, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Tony Bruce Camillo

Title

Managing Partner

Phone

(314) 646-8234

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1253318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337299200000",
    "number": "1023342391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2331 HAMPTON AVE",
            "address_2": "LOWER LEVEL",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631392908",
            "telephone_number": "314-646-8234",
            "fax_number": "314-646-8349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2331 HAMPTON AVE",
            "address_2": "LOWER LEVEL",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631392908",
            "telephone_number": "314-646-8234",
            "fax_number": "314-646-8349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLEGIANCE MEDICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-19",
        "last_updated": "2012-05-18",
        "status": "A",
        "authorized_official_last_name": "CAMILLO",
        "authorized_official_first_name": "TONY",
        "authorized_official_middle_name": "BRUCE",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "314-646-8234",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023342391",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Clinical Medical Laboratory in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.