| Organization Name: | ST. LOUIS CARDIOVASCULAR INSTITUTE, LLC |
| NPI Number: | 1053799007 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DAVID R HORACE (MANAGING MEMBER) |
| Mailing Address: | 1028 S Kirkwood Rd Kirkwood |
| State: | MO US |
| Postal Code: | 631227222 |
| Phone Number: | 3143942950 |
| Fax Number: | 3143942253 |
| NPI Enumeration Date: | 05/11/2015 |
| NPI Last Update Date: | 05/11/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Radiology |
| Taxonomy Definition: | |