Healthcare Provider Details
I. General information
NPI: 1922569300
Provider Name (Legal Business Name): ADAPTHEALTH - MISSOURI LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/27/2019
Last Update Date: 04/21/2021
Certification Date: 04/21/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
594 OLD ROUTE 66
SAINT ROBERT MO
65584-3729
US
IV. Provider business mailing address
220 W GERMANTOWN PIKE STE 250
PLYMOUTH MEETING PA
19462-1437
US
V. Phone/Fax
- Phone: 573-336-4111
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332BX2000X |
| Taxonomy | Oxygen Equipment & Supplies (DME) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
STEPHEN
GRIGGS
Title or Position: CEO
Credential:
Phone: 407-206-0040