MEDICARE: CARESTL HEALTH

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
2	3336M0002X	Mail Order Pharmacy	2005035951	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2639411	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number	:	1801197744
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARESTL HEALTH

Provider Business Mailing Address
First Line	:	2425 WHITTIER ST
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63113-2950
Country	:	US
Telephone Number	:	314-371-3100
Fax Number	:	314-535-4662

Provider Business Practice Location Address
First Line	:	2425 WHITTIER ST
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63113
Country	:	US
Telephone Number	:	314-371-3100
Fax Number	:	314-535-4662

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	MRS. ANGELA RENEE CLABON
Credential	:
Telephone Number	:	314-367-5820

Provider Enumeration Date	:	11/09/2010
Last Update Date	:	06/07/2018

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Directions to “CARESTL HEALTH ” Practice Location

Language	Start Address	Practice Location

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