MEDSOURCE OF ST. LOUIS, INC. (NPI# 1720001084) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720001084 |
| Entity Type | Organization |
| Organization Name | MEDSOURCE OF ST. LOUIS, INC. |
| Practice Address |
3394 Mckelvey Rd. Suite 102 Saint Louis MO 63044 |
| Practice Telephone | 3149661818 |
| Practice Fax Number | 3149661001 |
| Mailing Telephone | 3149661818 |
| Mailing Fax Number | 3149661001 |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2015-12-18 |
| Authorized Official Name | MRS. MARK COFFETT (PRESIDENT) |
| Authorized Official Telephone | 3149661818 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | 15710874 | MO | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | BLUE CROSS BLUE SHIELD | 29678 | 01 |
| MO | 626012405 | 05 |
| Street Address |
3394 MCKELVEY RD. SUITE 102 |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63044 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073150017 | Zoe Marie Wadsworth | Nurse Practitioner | 12255 Depaul Dr Suite 300, Bridgeton, MO 63044 | 2019-12-10 |
| 1609412451 | Beyond Better, Best Home Health Care Services, Limited Liability Corpo | In Home Supportive Care | 3430 Mckelvey Road Ste B, Bridgeton, MO 63044 | 2019-11-26 |
| 1275189078 | Delicate Angels Home Health LLC | Home Health | 11726 St. Charles Rock Road Suite G, Bridgeton, MO 63044 | 2019-08-16 |
| 1588210082 | Nicholas Huber | Physical Therapist | 12349 Depaul Dr., Ste. 110, Bridgeton, MO 63044 | 2019-08-12 |
| 1124688858 | Michelle Bassett | Registered Nurse | 11520 St. Charles Rock Rd., Suite 106, Bridgeton, MO 63044 | 2019-06-14 |
| 1336703883 | Elena A Barrow | Nurse Practitioner | 12255 Depaul Dr, Suite 260, Bridgeton, MO 63044 | 2019-04-30 |
| 1487123105 | Laura N Steiner | Registered Nurse | Gateway Pediatrics, Ltd, 12255 Depaul Drive, Suite 460 North Medical Building, Bridgeton, MO 63044 | 2018-11-26 |
| 1205310950 | Danielle Mathis | Nurse Practitioner | 3440 Depaul Lane Suite 201, Bridgeton, MO 63044 | 2018-09-19 |
| 1588163570 | Thoughts Out Loud Counseling, LLC | Social Worker | 11520 St. Charles Rock Road Suite 101, Bridgeton, MO 63044 | 2018-02-06 |
| 1912411430 | Breanna Victoria Hayes | Counselor | 3165 Mckevley Road, Suite 200, Bridgeton, MO 63044 | 2017-11-20 |
| Find all providers in zip 63044 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083228233 | Best Care Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 2200 W Port Plaza Dr Ste 220b, Saint Louis, MO 63146-3211 | 2020-09-04 |
| 1497368773 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 1430 Olive St Ste P, Saint Louis, MO 63103-2360 | 2020-08-26 |
| 1407475858 | Medical Supplies Only LLC | Durable Medical Equipment & Medical Supplies | 13035 Olive Blvd Ste 212, Saint Louis, MO 63141-6179 | 2020-04-15 |
| 1902437460 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 6211 Delmar Blvd, Saint Louis, MO 63130-4814 | 2020-02-03 |
| 1306494927 | The Whiteville Drugstore, LLC | Durable Medical Equipment & Medical Supplies | 13035 Olive Blvd Ste 210, Saint Louis, MO 63141-6179 | 2019-08-27 |
| 1669939773 | Midwest Respiratory Care Inc | Durable Medical Equipment & Medical Supplies | 115 Branch St, Saint Louis, MO 63147-3503 | 2019-02-25 |
| 1992276604 | Skin Relief Supply | Durable Medical Equipment & Medical Supplies | 10990 New Halls Ferry Rd Ste J110, Saint Louis, MO 63136-4471 | 2018-12-07 |
| 1497272165 | Mercy Pharmacy Services, LLC | Durable Medical Equipment & Medical Supplies | 607 S New Ballas Rd Ste 1415, Saint Louis, MO 63141-8231 | 2017-08-24 |
| 1972041283 | Anavan LLC | Durable Medical Equipment & Medical Supplies | 14390 Manchester Rd, Saint Louis, MO 63011 | 2017-02-07 |
| 1972048247 | Solutia Medical LLC | Durable Medical Equipment & Medical Supplies | 335 Leffingwell Ave, Suite126, Saint Louis, MO 63122-6417 | 2016-12-22 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63044 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.