NPIMap

Organization Active NPI

SSM Health Care St. Louis

Doing business as SSM Health Prescription Center

  • Community/Retail Pharmacy
  • O'Fallon, MO
National Provider Identifier
1639928690
Registry record updated May 19, 2025
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 Prescription Center
Practice address
301 Caledonia Pkwy Ste 110
O Fallon, MO 63368-6690
Phone
(636) 202-6810
Fax
(636) 202-6811
NPI assigned
May 14, 2024
Last updated
May 19, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
SSM HEALTH CARE ST. LOUISAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 19, 2025

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

Authorized official

Name
Jeremy Fotheringham
Title
Regional President
Phone
(314) 994-7930

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X NU Primary

Addresses

Primary practice location

301 Caledonia Pkwy Ste 110
O Fallon, MO 63368-6690

Mailing address

301 Caledonia Pkwy Ste 110
O Fallon, MO 63368-6690
Phone (636) 202-6810

Other names 1

  • SSM Health Prescription Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251017003552 MO DME Supplier - Pharmacy 7810800737 Practice locations: O Fallon, 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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
SSM Health Prescription Center301 Caledonia Pkwy, O Fallon, MO 63368-6690(636) 202-6810 Epoetin|Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Jan 1, 2001

National Provider Directory

National Provider Directory
Tax ID family
William D Huffstutler M15 organizations share this tax ID, including this one
Part of
William D Huffstutler M

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

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

NPI Registry JSON

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

{
    "created_epoch": "1715644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747612800000",
    "number": "1639928690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 CALEDONIA PKWY STE 110",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633686690",
            "telephone_number": "636-202-6810",
            "fax_number": "636-202-6811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 CALEDONIA PKWY STE 110",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633686690",
            "telephone_number": "636-202-6810",
            "fax_number": "636-202-6811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SSM HEALTH CARE ST. LOUIS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SSM HEALTH CARE ST. LOUIS",
        "enumeration_date": "2024-05-14",
        "last_updated": "2025-05-19",
        "certification_date": "2025-05-19",
        "status": "A",
        "authorized_official_last_name": "FOTHERINGHAM",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_title_or_position": "REGIONAL PRESIDENT",
        "authorized_official_telephone_number": "314-994-7930"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SSM Health Prescription Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SSM Health Prescription Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in O'Fallon, MO

Sources for this page

Verify at the official NPI Registry.