Healthcare Provider Details

I. General information

NPI: 1013136720
Provider Name (Legal Business Name): UNITED ACCESS, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 05/24/2023
Certification Date: 05/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 NW PLAZA DR STE 900
SAINT ANN MO
63074-2224
US

IV. Provider business mailing address

500 NORTHWEST PLAZA DR., STE 900
SAINT ANN MO
63074
US

V. Phone/Fax

Practice location:
  • Phone: 314-292-5113
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171WV0202X
TaxonomyVehicle Modifications Contractor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: CHAD BLAKE
Title or Position: SR VP OF STORE SALES AND OPERATIONS
Credential:
Phone: 623-399-3897