NPIMap

Organization Active NPI

Christian Hospital Northeast Northwest

  • Community/Retail Pharmacy
  • Saint Louis, MO
National Provider Identifier
1962518878
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
005670 Issued in MO
Legal business name
CHRISTIAN HOSPITAL NORTHEAST NORTHWEST
Practice address
11125 Dunn Rd
Saint Louis, MO 63136-6132
Phone
(314) 653-5200
Fax
(314) 653-4115
NPI assigned
Aug 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

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

Authorized official

Name
Susan Koesterer
Title
Vice President
Phone
(314) 653-5715

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 005670 MO Primary

Addresses

Primary practice location

11125 Dunn Rd
Saint Louis, MO 63136-6132

Mailing address

11125 Dunn Rd
Saint Louis, MO 63136-6132
Phone (314) 653-5200

Other identifiers 3

IdentifierTypeStateIssuer
436057983005MedicaidIL
606763514MedicaidMO
2051547OtherPK

Other names 1

  • FAMILY CARE PHARMACY AT CHRISTIAN HOSPITAL Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

National Provider Directory

National Provider Directory
Tax ID family
St Peters Emergency Phy7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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": "1156204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616025600000",
    "number": "1962518878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11125 DUNN RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631366132",
            "telephone_number": "314-653-5200",
            "fax_number": "314-653-4115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11125 DUNN RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631366132",
            "telephone_number": "314-653-5200",
            "fax_number": "314-653-4115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTIAN HOSPITAL NORTHEAST NORTHWEST",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-22",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A",
        "authorized_official_last_name": "KOESTERER",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "314-653-5715"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MO",
            "license": "005670",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "436057983005",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "606763514",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2051547",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "11125 Dunn Rd",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631366132",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "FAMILY CARE PHARMACY AT CHRISTIAN HOSPITAL",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "FAMILY CARE PHARMACY AT CHRISTIAN HOSPITAL",
            "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 Mar 18, 2021; 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.