| Organization Name: | ENDOSCOPY CENTER OF ST. LOUIS, LLC |
| NPI Number: | 1427273440 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KIM ANN LAWSON (OFFICE MANAGER) |
| Mailing Address: | 12990 Manchester Rd Suite 1 Des Peres |
| State: | MO US |
| Postal Code: | 631311804 |
| Phone Number: | 3149840550 |
| Fax Number: | 3149840501 |
| NPI Enumeration Date: | 04/16/2007 |
| NPI Last Update Date: | 11/29/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QE0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Endoscopy |
| Taxonomy Definition: | |