MEDICARE: BETHESDA SERVICES, 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	251G00000X	Community Based Hospice Care Agency	117-3HO	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

General Provider Information

NPI Number	:	1437125499
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BETHESDA SERVICES, INC

Provider Business Mailing Address
First Line	:	12101 WOODCREST EXECUTIVE DR STE 201
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63141-5016
Country	:	US
Telephone Number	:	314-800-1900
Fax Number	:	314-800-1961

Provider Business Practice Location Address
First Line	:	12101 WOODCREST EXECUTIVE DR STE 201
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63141-5016
Country	:	US
Telephone Number	:	314-800-1900
Fax Number	:	314-900-3683

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	MR. JOSEPH J BRINKER
Credential	:
Telephone Number	:	314-800-1986

Provider Enumeration Date	:	02/28/2006
Last Update Date	:	05/28/2025

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