MEDICARE: SIMPLY PEDIATRICS

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1447388491
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SIMPLY PEDIATRICS

Provider Business Mailing Address
First Line	:	6266 VISTA VIEW DR
Second Line	:
City	:	HOUSE SPRINGS
State	:	MO
Zip	:	63051-4346
Country	:	US
Telephone Number	:	314-941-4203
Fax Number	:

Provider Business Practice Location Address
First Line	:	6266 VISTA VIEW DR
Second Line	:
City	:	HOUSE SPRINGS
State	:	MO
Zip	:	63051-4346
Country	:	US
Telephone Number	:	314-941-4203
Fax Number	:

Authorized Official
Title or Position	:	PARTNER
Name	:	KRISTI SCANLON
Credential	:
Telephone Number	:	314-941-4203

Provider Enumeration Date	:	03/01/2007
Last Update Date	:	02/04/2008

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Directions to “SIMPLY PEDIATRICS ” Practice Location

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