MEDICARE: JAMES E PARKER

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		MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	57214	OTHER	MO	57214
2	110845	OTHER	MO	BCBS ITS UNIT
3	16952018	OTHER	MO	BLUE CROSS & BLUE SHIELD
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	257852	OTHER	MO	HEALTHLINK
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	82187	OTHER	MO	NORTHWOOD NPN (ELDON STOR

General Provider Information

NPI Number	:	1346224110
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAMES E PARKER

Provider Business Mailing Address
First Line	:	PO BOX 938
Second Line	:
City	:	CAMDENTON
State	:	MO
Zip	:	65020-0938
Country	:	US
Telephone Number	:	573-346-5556
Fax Number	:	573-346-5788

Provider Business Practice Location Address
First Line	:	802 N BUSINESS ROUTE 5
Second Line	:
City	:	CAMDENTON
State	:	MO
Zip	:	65020-2646
Country	:	US
Telephone Number	:	573-346-5556
Fax Number	:	573-346-5788

Authorized Official
Title or Position	:	OWNER
Name	:	MR. JAMES EARL PARKER
Credential	:
Telephone Number	:	573-346-5556

Provider Enumeration Date	:	12/05/2005
Last Update Date	:	07/21/2022

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Directions to “JAMES E PARKER ” Practice Location

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