MEDICARE: MEDIEQUIP, INC

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306813258
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDIEQUIP, INC

Provider Business Mailing Address
First Line	:	5845 S LINDBERGH BLVD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63123-6948
Country	:	US
Telephone Number	:	314-892-7000
Fax Number	:	314-329-9209

Provider Business Practice Location Address
First Line	:	5845 S LINDBERGH BLVD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63123-6948
Country	:	US
Telephone Number	:	314-892-7000
Fax Number	:	314-329-9209

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. DONALD D INGERSON
Credential	:
Telephone Number	:	314-892-7000

Provider Enumeration Date	:	02/28/2006
Last Update Date	:	06/02/2008

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Directions to “MEDIEQUIP, INC ” Practice Location

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