MEDICARE: THE BIOME

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	251300000X	Local Education Agency (LEA)

General Provider Information

NPI Number	:	1295260248
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE BIOME

Provider Business Mailing Address
First Line	:	4471 OLIVE ST
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63108-1807
Country	:	US
Telephone Number	:	314-531-0982
Fax Number	:

Provider Business Practice Location Address
First Line	:	4471 OLIVE ST
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63108-1807
Country	:	US
Telephone Number	:	314-531-0982
Fax Number	:

Authorized Official
Title or Position	:	SCHOOL ACCOUNTANT
Name	:	DEBBIE AKINS
Credential	:
Telephone Number	:	314-702-3214

Provider Enumeration Date	:	04/27/2017
Last Update Date	:	04/27/2017

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Directions to “THE BIOME ” Practice Location

Language	Start Address	Practice Location

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