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NPI Code Detail

MEDICARE: CARESTL HEALTH

MEDICARE: CARESTL HEALTH
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
1291U00000XClinical Medical Laboratory29D1039190CLIAMO

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 : 1568504488
Entity Type Code : Organization
Provider Name (Legal Business Name) : CARESTL HEALTH
Provider Business Mailing Address
First Line : 5471 DR MARTIN LUTHER KING DRIVE
Second Line :
City : ST LOUIS
State : MO
Zip : 63112-4265
Country : US
Telephone Number : 314-367-5820
Fax Number : 314-367-7010
Provider Business Practice Location Address
First Line : 5541 RIVERVIEW BLD
Second Line :
City : ST LOUIS
State : MO
Zip : 63120
Country : US
Telephone Number : 314-389-4566
Fax Number : 314-385-7859
Authorized Official
Title or Position : CHIEF EXECUTIVE OFFICER
Name : MRS. ANGELA RENEE CLABON
Credential :
Telephone Number : 314-367-5820
Provider Enumeration Date : 02/14/2007
Last Update Date : 06/06/2018

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Directions to “CARESTL HEALTH ” Practice Location

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