=====================================================
General NPI Number Information
=====================================================
NPI Number | 1235326273
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | COURIER HEALTHCARE SYSTEMS, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/03/2007
-----------------------------------------------------
Last Update Date | 06/10/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10420 OLD OLIVE STREET RD SUITE 101
-----------------------------------------------------
City | CREVE COEUR
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 63141-5914
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 314-872-7774
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10420 OLD OLIVE STREET RD SUITE 101
-----------------------------------------------------
City | CREVE COEUR
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 63141-5914
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 314-872-7774
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | P
-----------------------------------------------------
Name | SHEILA R DALTON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 314-872-7774
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 267641306
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------