MEDICARE: PICKY GIRL LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	163WP0000X	Pain Management Registered Nurse
2	1835P1400X	Pain Management Pharmacist
3	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician
4	207LP2900X	Pain Medicine (Anesthesiology) Physician

General Provider Information

NPI Number	:	1518816685
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PICKY GIRL LLC

Provider Business Mailing Address
First Line	:	919 SHERWOOD DR
Second Line	:
City	:	WARRENTON
State	:	MO
Zip	:	63383-2241
Country	:	US
Telephone Number	:	408-748-4101
Fax Number	:	833-491-1161

Provider Business Practice Location Address
First Line	:	919 SHERWOOD DR
Second Line	:
City	:	WARRENTON
State	:	MO
Zip	:	63383-2241
Country	:	US
Telephone Number	:	408-748-4101
Fax Number	:	833-491-1161

Authorized Official
Title or Position	:	CEO
Name	:	MR. HEMANTA ROY
Credential	:
Telephone Number	:	408-748-4101

Provider Enumeration Date	:	01/22/2026
Last Update Date	:	01/22/2026

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Directions to “PICKY GIRL LLC ” Practice Location

Language	Start Address	Practice Location

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