Healthcare Provider Details

I. General information

NPI: 1770037731
Provider Name (Legal Business Name): DREW BOST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2016
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 S HIGHLAND DR
MANY LA
71449-3719
US

IV. Provider business mailing address

1609 MOCKINGBIRD CT STE B
FLORENCE AL
35630-7511
US

V. Phone/Fax

Practice location:
  • Phone: 318-256-5200
  • Fax:
Mailing address:
  • Phone: 601-988-5693
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number1083162465
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6191C
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: