ADVANCED HEART CARE NPI 1356590178

NPI Information

ADVANCED HEART CARE is a clinic center in Belleville, IL. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). ADVANCED HEART CARE NPI is 1356590178. The provider is registered as an organization entity type.

The provider's business location address is:

4600 MEMORIAL DR
W3
BELLEVILLE, IL
ZIP 62226-366
Phone: (618) 222-8900
Fax: (618) 222-8950

The provider's authorized official is Omar Almousalli .
The authorized official title is Owner and has the following contact phone number (618) 222-8900.

The CLIA number assigned to this NPI record is 14D1097779 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/17/2008 and was last updated on 1/8/2015.

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:

Other Identifiers

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

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