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General NPI Number Information
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NPI Number | 1215211636
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Entity Type | Organization
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Legal Business Name | HEALTH AID SUPPLIES, LLC
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Dates
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Enumeration Date | 10/04/2011
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Last Update Date | 02/04/2014
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Provider Practice Location Address
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Address Line | 107 CREEKSIDE OFFICE DR
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City | WENTZVILLE
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State | MO
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Zip | 63385-3289
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Country | US
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Telephone | 314-324-5554
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Fax | 636-327-6863
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Provider Business Mailing Address
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Address Line | 107 CREEKSIDE OFFICE DR
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City | WENTZVILLE
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State | MO
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Zip | 63385-3289
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Country | US
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Telephone | 314-324-5554
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Fax | 636-327-6863
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Authorized Official
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Title or Position | OWNER
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Name | DAVID RUSSELL MOSS
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Credential |
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Telephone | 314-324-5554
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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 |
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License Number State |
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