Healthcare Provider Details

I. General information

NPI: 1992737985
Provider Name (Legal Business Name): STEELE NO 1 INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 08/30/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 N WALNUT ST
STEELE MO
63877-1355
US

IV. Provider business mailing address

PO BOX 1210
SIKESTON MO
63801-1210
US

V. Phone/Fax

Practice location:
  • Phone: 573-695-2121
  • Fax: 573-695-4624
Mailing address:
  • Phone: 573-471-1276
  • Fax: 573-472-8504

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number045219
License Number StateMO

VIII. Authorized Official

Name: DONALD B BEDELL
Title or Position: PRESIDENT
Credential:
Phone: 573-471-1276