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General NPI Number Information
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NPI Number | 1609481696
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Entity Type | Organization
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Legal Business Name | MEDICAL CARE LLC
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Dates
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Enumeration Date | 09/15/2020
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Last Update Date | 01/20/2025
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Provider Practice Location Address
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Address Line | 2686 N HIGHWAY 67
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City | FLORISSANT
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State | MO
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Zip | 63033-1438
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Country | US
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Telephone | 314-436-9300
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Fax | 833-467-1417
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Provider Business Mailing Address
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Address Line | 2686 N HIGHWAY 67
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City | FLORISSANT
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State | MO
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Zip | 63033-1438
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Country | US
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Telephone | 314-436-9300
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Fax | 833-467-1417
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Authorized Official
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Title or Position | OWNER
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Name | CHRISTOPHER LONG
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Credential |
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Telephone | 314-377-3349
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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