| |
1011 Bowles Ave, Suite 123, Fenton, MO 63026-2395 | |
(314) 991-3668 | |
(314) 991-3665 |
Full Name | |
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Type | Facility |
Speciality | Durable Medical Equipment & Medical Supplies |
Location | 1011 Bowles Ave, Fenton, Missouri |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1013204692 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213ES0103X | Podiatrist - Foot & Ankle Surgery | (* (Not Available)) | Secondary |
332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
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Po Box 771754, Saint Louis, MO 63177-1754 Ph: (314) 989-0300 | 1011 Bowles Ave, Suite 123, Fenton, MO 63026-2395 Ph: (314) 991-3668 |