Healthcare Provider Details

I. General information

NPI: 1740042928
Provider Name (Legal Business Name): CARESTL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2024
Last Update Date: 01/24/2024
Certification Date: 01/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10135 W FLORISSANT AVE
SAINT LOUIS MO
63136-2103
US

IV. Provider business mailing address

10135 W FLORISSANT AVE
SAINT LOUIS MO
63136-2103
US

V. Phone/Fax

Practice location:
  • Phone: 314-367-5820
  • Fax: 314-361-2831
Mailing address:
  • Phone: 314-367-5820
  • Fax: 314-361-2831

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MRS. ANGELA RENEE ARCHIBALD- CLABON
Title or Position: PRESIDENT/CEO
Credential:
Phone: 314-623-9266