| South City Hospital | |
|
3933 South Broadway Street St Louis MO 63118-4601 | |
| (314) 865-7902 | |
| (314) 865-7938 |
| Full Name | South City Hospital |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 3933 South Broadway Street, St Louis, Missouri |
| Authorized Official Name and Position | Bianca Defilippi (CEO) |
| Authorized Official Contact | 3148657917 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| South City Hospital 3933 South Broadway Street St Louis MO 63118-4601 Ph: (314) 865-7902 | South City Hospital 3933 South Broadway Street St Louis MO 63118-4601 Ph: (314) 865-7902 |
| NPI Number | 1023017746 |
|---|---|
| Provider Enumeration Date | 07/14/2005 |
| Last Update Date | 03/29/2023 |
| Certification Date | 03/29/2023 |
| Medicare PECOS PAC ID | 1658783915 |
|---|---|
| Medicare Enrollment ID | O20210204000185 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023017746 | NPI | - | NPPES |
| 010635001 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 512-1 (Missouri) | Primary |
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