Provider Demographics
NPI:1447337449
Name:KINDRED HOSPITALS EAST, LLC
Entity type:Organization
Organization Name:KINDRED HOSPITALS EAST, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT, CORPORATE SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:TEAGUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:629-253-5121
Mailing Address - Street 1:4930 LINDELL BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63108-1510
Mailing Address - Country:US
Mailing Address - Phone:314-361-8700
Mailing Address - Fax:314-361-1210
Practice Address - Street 1:4930 LINDELL BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63108-1510
Practice Address - Country:US
Practice Address - Phone:314-361-8700
Practice Address - Fax:314-361-1210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO013126404Medicaid
MO188OtherBLUE CROSS
MO188OtherBLUE CROSS
MO=========OtherHUMANA
MO=========OtherTRICARE/CHAMPUS
MO=========OtherCIGNA
MO=========OtherGREAT WEST
MO013126404Medicaid
MO=========OtherAETNA
26-2010Medicare Oscar/Certification