MEDICARE: PERSONAL CARE PRODUCTS, 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	17139112	MO

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
12	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
13	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376552208
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PERSONAL CARE PRODUCTS, INC.

Provider Business Mailing Address
First Line	:	500 HUBER PARK CT
Second Line	:	SUITE 106
City	:	WELDON SPRING
State	:	MO
Zip	:	63304-8683
Country	:	US
Telephone Number	:	800-575-0302
Fax Number	:	636-536-1242

Provider Business Practice Location Address
First Line	:	500 HUBER PARK CT
Second Line	:	SUITE 106
City	:	WELDON SPRING
State	:	MO
Zip	:	63304-8683
Country	:	US
Telephone Number	:	800-575-0302
Fax Number	:	636-536-1242

Authorized Official
Title or Position	:	OWNER
Name	:	MR. BRAD R STATLER
Credential	:
Telephone Number	:	636-536-4152

Provider Enumeration Date	:	08/07/2006
Last Update Date	:	05/05/2014

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