Organization · Type 2 NPI

Ste. Genevieve County Memorial Hospital

Foot Surgery Podiatrist · Bloomsdale, MO

NPI number 1104692946 Active

Practice location

255 Boderman Ste 2C
Bloomsdale, MO 63627-9099

Call (573) 883-2751 Map

Mailing address

800 Ste Genevieve Dr
Ste Genevieve, MO 63670-1434

Specialties and licenses

Taxonomy	Code	License
Foot Surgery Podiatrist Primary	213ES0131X	None listed

Foot Surgery Podiatrist: Definition to come...

NPI record

NPI: 1104692946
Entity type: Organization (Type 2)
Issued: Dec 4, 2023
Last updated: Sep 11, 2026
Status: Active
Subpart: Yes of Ste Genevieve County Memorial Hospital

Other names

Bloomsdale Specialty Clinic · doing business as

Authorized official

Scott Griffin
Revenue Cycle Director
(573) 883-2751

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1104692946

Ste. Genevieve County Memorial Hospital's National Provider Identifier is 1104692946, issued on Dec 4, 2023. The primary taxonomy on file is Foot Surgery Podiatrist (213ES0131X), and the practice location is in Bloomsdale, MO. The record was last updated on Sep 11, 2026.