MEDICARE: SIMPLY HEALTH INTEGRATED MEDICAL LLC

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
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1679175988
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SIMPLY HEALTH INTEGRATED MEDICAL LLC

Provider Business Mailing Address
First Line	:	126 HILLTOWN VILLAGE CTR
Second Line	:
City	:	CHESTERFIELD
State	:	MO
Zip	:	63017-0709
Country	:	US
Telephone Number	:	630-590-4686
Fax Number	:	888-859-4926

Provider Business Practice Location Address
First Line	:	12977 N 40 DR STE 105
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63141-8654
Country	:	US
Telephone Number	:	630-590-4686
Fax Number	:	636-206-8361

Authorized Official
Title or Position	:	OWNER
Name	:	BRYAN DELONEY
Credential	:
Telephone Number	:	636-590-4686

Provider Enumeration Date	:	11/11/2020
Last Update Date	:	12/12/2024

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Directions to “SIMPLY HEALTH INTEGRATED MEDICAL LLC ” Practice Location

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