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General NPI Number Information
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NPI Number | 1033442348
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Entity Type | Organization
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Legal Business Name | REGIMED MEDICAL
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Dates
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Enumeration Date | 09/18/2009
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Last Update Date | 09/18/2009
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Provider Practice Location Address
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Address Line | 106 ARABIAN PATH
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City | SAINT PETERS
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State | MO
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Zip | 63376-1798
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Country | US
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Telephone | 636-240-1515
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Fax | 636-240-2941
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Provider Business Mailing Address
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Address Line | 106 ARABIAN PATH
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City | SAINT PETERS
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State | MO
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Zip | 63376-1798
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Country | US
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Telephone | 636-240-1515
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Fax | 636-240-2941
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. REGINALD MACLIN
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Credential |
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Telephone | 636-240-1515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 2001015969
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License Number State | MO
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