| Pedirite Medical Mo Llc | |
|
1265 Mclaran Ave Saint Louis MO 63147-1606 | |
| (212) 764-0008 | |
| Not Available |
| Full Name | Pedirite Medical Mo Llc |
|---|---|
| Speciality | General Practice |
| Location | 1265 Mclaran Ave, Saint Louis, Missouri |
| Authorized Official Name and Position | Solomon Klein (MEMBER) |
| Authorized Official Contact | 2127640008 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pedirite Medical Mo Llc 267 Broadway Fl 2 Brooklyn NY 11211-6216 Ph: (212) 764-0008 | Pedirite Medical Mo Llc 1265 Mclaran Ave Saint Louis MO 63147-1606 Ph: (212) 764-0008 |
| NPI Number | 1538880109 |
|---|---|
| Provider Enumeration Date | 09/12/2022 |
| Last Update Date | 09/12/2022 |
| Medicare PECOS PAC ID | 4587049721 |
|---|---|
| Medicare Enrollment ID | O20220923001817 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538880109 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Charles S Ginn |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1528251956 PECOS PAC ID: 3072705201 Enrollment ID: I20211117000668 |
| Provider Name | Carl Kurzel |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1891282588 PECOS PAC ID: 5395092613 Enrollment ID: I20230615002881 |
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