Provider Type Icon

MIA OF ST CHARLES COUNTY LLC NPI 1922093632


NPI Information

NPI: 1922093632
Provider Name: MIA OF ST CHARLES COUNTY LLC

Doing Business As: CLINICAL PET OF ST CHARLES COUNTY

Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Address:
1475 KISKER RD
STE 145
SAINT CHARLES, MO
ZIP 63304
Phone: (636) 922-5151
Get Directions

MIA OF ST CHARLES COUNTY LLC is a clinic center in Saint Charles, MO. 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). MIA OF ST CHARLES COUNTY LLC NPI is 1922093632. The provider is registered as an organization entity type.
The provider Is Doing Business As Clinical Pet Of St Charles County.

The provider's business location address is:

1475 KISKER RD
STE 145
SAINT CHARLES, MO
ZIP 63304-781
Phone: (636) 922-5151
Fax: (636) 922-5454

The provider's authorized official is Steven Michael Mcrae .
The authorized official title is Managing Member and has the following contact phone number (618) 659-1167.

The enumeration date for this NPI number is 9/19/2005 and was last updated on 8/22/2020.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261Q00000XClinic/CenterYes

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: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.