MEDICARE: SSM DIVERSIFIED CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	12198510	MO

General Provider Information

NPI Number	:	1285639039
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SSM DIVERSIFIED CORPORATION

Provider Business Mailing Address
First Line	:	10143 PAGET DR
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63132-2915
Country	:	US
Telephone Number	:	888-705-6060
Fax Number	:	314-989-2556

Provider Business Practice Location Address
First Line	:	10143 PAGET DR
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63132-2915
Country	:	US
Telephone Number	:	888-705-6060
Fax Number	:	314-989-2556

Authorized Official
Title or Position	:	VP
Name	:	MR. WILLIAM SCHOENHARD
Credential	:
Telephone Number	:	314-994-7900

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	08/22/2020

Similar Medicare Providers

1780645424 — DR. NEAL D. BAYES D.D.S.
Practice Location Address:

12966 TESSON FERRY RD
SAINT LOUIS, MO
63128-2915

Practice Phone: 314-842-5200
Practice Fax:

1487612941 — DR. SUSAN REIS BUTLER DOCTORATE
Practice Location Address:

12962 TESSON FERRY RD
SAINT LOUIS, MO
63128-2915

Practice Phone: 314-849-7177
Practice Fax:

1699860734 — DR. KEVIN E. GROTH DMD
Practice Location Address:

2915 S BRENTWOOD BLVD
SAINT LOUIS, MO
63144-2713

Practice Phone: 314-962-6622
Practice Fax: 314-961-2288

1174618045 — PRESTIGE DENTAL CARE, LLC
Practice Location Address:

2915 S BRENTWOOD BLVD
SAINT LOUIS, MO
63144-2713

Practice Phone: 314-962-6622
Practice Fax: 314-961-2288

1558579821 — NANCY A PARK PHARM.D.
Practice Location Address:

7427 OXFORD DR
SAINT LOUIS, MO
63105-2915

Practice Phone: 314-409-2020
Practice Fax:

1972772101 — WALGREEN CO
Practice Location Address:

3527 CHOUTEAU AVE
SAINT LOUIS, MO
63103-2915

Practice Phone: 314-771-2900
Practice Fax: 314-771-2955

Directions to “SSM DIVERSIFIED CORPORATION ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.