Healthcare Provider Details

I. General information

NPI: 1164012316
Provider Name (Legal Business Name): SQUARED AWAY VETERANS EXPRESS (SAVE)
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2021
Last Update Date: 01/26/2021
Certification Date: 01/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

134 SAW MILL RD
SAINT ROBERT MO
65584-4711
US

IV. Provider business mailing address

134 SAW MILL RD
SAINT ROBERT MO
65584-4711
US

V. Phone/Fax

Practice location:
  • Phone: 949-293-8851
  • Fax:
Mailing address:
  • Phone: 949-293-8851
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332000000X
TaxonomyMilitary/U.S. Coast Guard Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332100000X
TaxonomyDepartment of Veterans Affairs (VA) Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code335G00000X
TaxonomyMedical Foods Supplier
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3418M1110X
TaxonomyMilitary or U.S. Coast Guard Ground Transport Ambulance
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 8
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL DAVID
Title or Position: CFO
Credential: CERTIFIED CAREGIVER
Phone: 949-293-8851