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General NPI Number Information
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NPI Number | 1477913317
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Entity Type | Organization
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Legal Business Name | STAR CONSUMER DIRECTED SERVICES ST LOUIS, LLC
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Dates
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Enumeration Date | 03/04/2016
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Last Update Date | 03/04/2016
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Provider Practice Location Address
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Address Line | 2075 WALTON RD
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City | OVERLAND
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State | MO
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Zip | 63114-5805
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Country | US
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Telephone | 314-426-1234
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Fax | 800-361-2345
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Provider Business Mailing Address
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Address Line | 5958 WYCLIFFE DR
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City | WELDON SPRING
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State | MO
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Zip | 63304-7827
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Country | US
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Telephone | 314-324-8901
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Fax | 800-361-2345
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Authorized Official
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Title or Position | OWNER/ MEMBER
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Name | DR. REBECCA BRIGGS
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Credential | PHARMD
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Telephone | 314-324-8901
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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