NPIMap

Organization Active NPI

Saint Louis Renal Care, LLC

Doing business as St. Louis Renal Care - Prince Hall

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Saint Louis, MO
National Provider Identifier
1790845196
Registry record updated Oct 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
SAINT LOUIS RENAL CARE, LLC
Doing business as
St. Louis Renal Care - Prince Hall
Practice address
4411 N Newstead Ave
2ND Floor
Saint Louis, MO 63115
Phone
(314) 381-7696
NPI assigned
Dec 8, 2006
Organization subpart
Yes
Parent organization
FRESENIUS MEDICAL CARE HOLDINGS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 15, 2008

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

Authorized official

Name
Mark Fawcett
Title
Treasurer
Phone
(781) 699-9000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X Primary

Addresses

Primary practice location

4411 N Newstead Ave
2ND Floor
Saint Louis, MO 63115

Mailing address

4411 N Newstead Ave
2ND Floor
Saint Louis, MO 63115

Other names 1

  • ST. LOUIS RENAL CARE - PRINCE HALL Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ability Network5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224028800000",
    "number": "1790845196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4411 N NEWSTEAD AVE",
            "address_2": "2ND FLOOR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "63115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4411 N NEWSTEAD AVE",
            "address_2": "2ND FLOOR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "63115",
            "telephone_number": "314-381-7696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT LOUIS RENAL CARE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRESENIUS MEDICAL CARE HOLDINGS, INC.",
        "enumeration_date": "2006-12-08",
        "last_updated": "2008-10-15",
        "status": "A",
        "authorized_official_last_name": "FAWCETT",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "781-699-9000"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ST. LOUIS RENAL CARE - PRINCE HALL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2008; 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.