Healthcare Provider Details

I. General information

NPI: 1801718895
Provider Name (Legal Business Name): MEDCURO MANUFACTURING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11605 STUDT AVE STE 105
SAINT LOUIS MO
63141-7052
US

IV. Provider business mailing address

4200 N CLOVERLEAF DR STE A
SAINT PETERS MO
63376-6436
US

V. Phone/Fax

Practice location:
  • Phone: 314-814-4607
  • Fax: 314-567-8593
Mailing address:
  • Phone: 314-814-4607
  • Fax: 636-477-6971

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: ANTHONY JOHN PAGANO
Title or Position: PARTNER
Credential:
Phone: 314-814-4607