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NPI Code Detail

MEDICARE: RANKEN-JORDAN HOME FOR CONVALESCENT CRIPPLED CHILDREN

MEDICARE: RANKEN-JORDAN HOME FOR CONVALESCENT CRIPPLED CHILDREN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1282N00000XGeneral Acute Care Hospital472-3MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1235117532
Entity Type Code : Organization
Provider Name (Legal Business Name) : RANKEN-JORDAN HOME FOR CONVALESCENT CRIPPLED CHILDREN
Provider Business Mailing Address
First Line : 11365 DORSETT RD
Second Line :
City : MARYLAND HEIGHTS
State : MO
Zip : 63043-3411
Country : US
Telephone Number : 314-872-6400
Fax Number : 314-872-6500
Provider Business Practice Location Address
First Line : 11365 DORSETT RD
Second Line :
City : MARYLAND HEIGHTS
State : MO
Zip : 63043-3411
Country : US
Telephone Number : 314-872-6400
Fax Number : 314-872-6500
Authorized Official
Title or Position : CEO
Name : MR. SHAWN DRYDEN
Credential :
Telephone Number : 314-872-6400
Provider Enumeration Date : 01/06/2006
Last Update Date : 07/03/2025

Similar Medicare Providers

1609728831 — GRACE EDERER RN
Practice Location Address:
11365 DORSETT RD
MARYLAND HEIGHTS, MO
63043-3411
Practice Phone: 314-872-6400
Practice Fax:
1447607965 — MARY MARGARET HILL APRN
Practice Location Address:
11365 DORSETT RD
MARYLAND HEIGHTS, MO
63043-3411
Practice Phone: 314-872-6400
Practice Fax: 314-872-6500
1134195654 — DR. SUSAN CONGER M.D.
Practice Location Address:
11365 DORSETT RD
MARYLAND HEIGHTS, MO
63043-3411
Practice Phone: 314-872-6400
Practice Fax: 314-872-6500
1669448098 — MARGARET J ONEY PNP
Practice Location Address:
11365 DORSETT RD
MARYLAND HEIGHTS, MO
63043-3411
Practice Phone: 314-872-6400
Practice Fax: 314-872-6500
1841266749 — NICHOLAS A HOLEKAMP MD
Practice Location Address:
11365 DORSETT RD
MARYLAND HEIGHTS, MO
63043-3411
Practice Phone: 314-872-6400
Practice Fax: 314-872-6500
1275509226 — ROSA M SUAREZ-SOLAR MD
Practice Location Address:
11365 DORSETT RD
MARYLAND HEIGHTS, MO
63043-3411
Practice Phone: 314-872-6400
Practice Fax: 314-872-6500

Directions to “RANKEN-JORDAN HOME FOR CONVALESCENT CRIPPLED CHILDREN ” Practice Location

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