Healthcare Provider Details

I. General information

NPI: 1053976431
Provider Name (Legal Business Name): U AUTO BE QUIK LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2019
Last Update Date: 05/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10352 CASTLE DRIVE
ST. LOUIS MO
63136
US

IV. Provider business mailing address

10352 CASTLE DRIVE
ST. LOUIS MO
63136
US

V. Phone/Fax

Practice location:
  • Phone: 314-562-1693
  • Fax:
Mailing address:
  • Phone: 314-738-9701
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: MR. DARYL LEON SMITH
Title or Position: CEO
Credential:
Phone: 314-562-1693