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MBS ADVANTAGE INC NPI 1083612253


NPI Information

NPI: 1083612253
Provider Name: MBS ADVANTAGE INC
Classification: General Practice - 208D00000X
Entity Type: Organization
Address:
11618 GRAVOIS RD
SAINT LOUIS, MO
ZIP 63126
Phone: (314) 842-1900
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MBS ADVANTAGE INC is a general practice in Saint Louis, MO. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee MBS ADVANTAGE INC NPI is 1083612253. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

11618 GRAVOIS RD
SAINT LOUIS, MO
ZIP 63126-014
Phone: (314) 842-1900
Fax: (314) 842-9185

The provider's authorized official is Jean L Foster .
The authorized official title is President and has the following contact phone number (314) 842-1900.

The enumeration date for this NPI number is 7/12/2005 and was last updated on 3/11/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208D00000XGeneral Practice207927ILLINOISNo
2235Z00000XSpeech-Language Pathologist102623MISSOURINo
3235Z00000XSpeech-Language Pathologist146004057ILLINOISNo
4208D00000XGeneral Practice000014833MISSOURIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1500893409MEDICAIDMISSOURI
2207927MEDICARE ID-TYPE UNSPECIFIEDILLINOIS
3000014833MEDICARE ID-TYPE UNSPECIFIEDMISSOURI
4271325663MEDICAIDILLINOIS
5121947OTHERBCBS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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