MEDICARE: BIOTAB LLC

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

General Provider Information

NPI Number	:	1891689287
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BIOTAB LLC

Provider Business Mailing Address
First Line	:	11701 BORMAN DR STE 107
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63146-4264
Country	:	US
Telephone Number	:	877-246-8220
Fax Number	:

Provider Business Practice Location Address
First Line	:	5909 SHELBY OAKS DR STE 121
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38134-7318
Country	:	US
Telephone Number	:	901-441-5693
Fax Number	:

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	EVAN HALL
Credential	:
Telephone Number	:	314-812-3949

Provider Enumeration Date	:	06/09/2025
Last Update Date	:	06/09/2025

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