Healthcare Provider Details

I. General information

NPI: 1578869715
Provider Name (Legal Business Name): N AND N HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2011
Last Update Date: 02/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4225 BAYLESS AVE
SAINT LOUIS MO
63123-7513
US

IV. Provider business mailing address

4225 BAYLESS AVE
SAINT LOUIS MO
63123-7513
US

V. Phone/Fax

Practice location:
  • Phone: 314-363-7960
  • Fax: 636-942-1021
Mailing address:
  • Phone: 314-363-7960
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: SHAWN NASH
Title or Position: CO-OWNER
Credential:
Phone: 314-363-7960