Healthcare Provider Details

I. General information

NPI: 1518952449
Provider Name (Legal Business Name): MED RESOURCES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2005
Last Update Date: 02/16/2021
Certification Date: 02/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15464 OLIVE BOULEVARD SUITE 100
CHESTERFIELD MO
63017-1719
US

IV. Provider business mailing address

15464 OLIVE BOULEVARD SUITE 100
CHESTERFIELD MO
63017-1719
US

V. Phone/Fax

Practice location:
  • Phone: 636-733-7200
  • Fax: 636-733-7202
Mailing address:
  • Phone: 636-733-7200
  • Fax: 636-733-7202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: JEFF BRAUN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 636-733-7200