Healthcare Provider Details

I. General information

NPI: 1356612485
Provider Name (Legal Business Name): ABDULLAH ARSHAD, MD., LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2012
Last Update Date: 09/19/2024
Certification Date: 09/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11796 WESTLINE INDUSTRIAL DR
SAINT LOUIS MO
63146-3402
US

IV. Provider business mailing address

11796 WESTLINE INDUSTRIAL DR
SAINT LOUIS MO
63146-3402
US

V. Phone/Fax

Practice location:
  • Phone: 573-359-5546
  • Fax:
Mailing address:
  • Phone: 314-282-2957
  • Fax: 314-610-8206

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: DEBRA M. CLARK
Title or Position: VICE CHAIRMAN OF THE BOARD
Credential: RN
Phone: 901-881-0645