Healthcare Provider Details

I. General information

NPI: 1356404784
Provider Name (Legal Business Name): MUELLER ELECTRIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 S MAIN ST
DE SOTO MO
63020-2106
US

IV. Provider business mailing address

324 S MAIN ST
DE SOTO MO
63020-2106
US

V. Phone/Fax

Practice location:
  • Phone: 636-586-3308
  • Fax: 636-586-2092
Mailing address:
  • Phone: 636-586-3308
  • Fax: 636-586-2092

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number10512691
License Number StateMO

VIII. Authorized Official

Name: MRS. ANDREA LEE PATTERSON
Title or Position: OFFICE COORDINATOR
Credential:
Phone: 636-586-3308