Healthcare Provider Details

I. General information

NPI: 1205969565
Provider Name (Legal Business Name): STRICTLY PEDIATRICS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

56 WORTHINGTON ACCESS DRIVE
MARYLAND HEIGHTS MO
63043
US

IV. Provider business mailing address

56 WORTHINGTON ACCESS DR
MARYLAND HEIGHTS MO
63043-3806
US

V. Phone/Fax

Practice location:
  • Phone: 314-439-0800
  • Fax: 314-439-0801
Mailing address:
  • Phone: 314-439-0800
  • Fax: 314-439-0801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3140N1450X
TaxonomyPediatric Skilled Nursing Facility
License Number296-15
License Number StateMO

VIII. Authorized Official

Name: MRS. DEBORAH S RAGSDALE
Title or Position: BILLING MANAGER
Credential:
Phone: 314-439-0800