Healthcare Provider Details

I. General information

NPI: 1720245376
Provider Name (Legal Business Name): ARENOS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2008
Last Update Date: 02/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3009 N BALLAS RD SUITE 129A
SAINT LOUIS MO
63131-2322
US

IV. Provider business mailing address

3009 N BALLAS RD SUITE 129A
SAINT LOUIS MO
63131-2322
US

V. Phone/Fax

Practice location:
  • Phone: 314-567-5377
  • Fax: 314-567-5376
Mailing address:
  • Phone: 314-567-5377
  • Fax: 314-567-5376

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number34824
License Number StateMO

VIII. Authorized Official

Name: DR. PROCESO T ARENOS JR.
Title or Position: OWNER
Credential: MD
Phone: 314-567-5377