MEDICARE: NU-CROWN, 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	152W00000X	Optometrist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	14052	OTHER	MO	SPECTERA

General Provider Information

NPI Number	:	1952469041
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NU-CROWN, LLC

Provider Business Mailing Address
First Line	:	211 E BROADWAY
Second Line	:
City	:	ALTON
State	:	IL
Zip	:	62002-6220
Country	:	US
Telephone Number	:	618-462-9818
Fax Number	:	800-432-6004

Provider Business Practice Location Address
First Line	:	4145 LINDELL BLVD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63108-2913
Country	:	US
Telephone Number	:	314-533-1898
Fax Number	:	800-432-6004

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. CHARLES D. MATTHEWS
Credential	:
Telephone Number	:	618-462-9818

Provider Enumeration Date	:	12/04/2006
Last Update Date	:	04/21/2017

Similar Medicare Providers

1710946991 — DR. BRIAN D. LOPATIN O.D.
Practice Location Address:

4145 LINDELL BLVD
SAINT LOUIS, MO
63108-2913

Practice Phone: 314-533-1898
Practice Fax: 800-432-6004

1013943539 — MISSOURI CVS PHARMACY, L.L.C.
Practice Location Address:

4171 LINDELL BLVD
ST. LOUIS, MO
63108-2913

Practice Phone: 314-533-8234
Practice Fax: 314-535-2109

1790261956 — JAMIE DICKERSON PHARMD
Practice Location Address:

4171 LINDELL BLVD
SAINT LOUIS, MO
63108-2913

Practice Phone: 314-533-8234
Practice Fax:

1750867941 — LORI ANNE MILLS
Practice Location Address:

4171 LINDELL BLVD
SAINT LOUIS, MO
63108-2913

Practice Phone: 314-533-8234
Practice Fax:

1689150872 — DAVID LOHMEYER RPH
Practice Location Address:

4171 LINDELL BLVD
SAINT LOUIS, MO
63108-2913

Practice Phone: 314-533-8234
Practice Fax: 314-535-2109

1831704725 — CHIRO ONE WELLNESS CENTER OF CENTRAL WEST END, LLC
Practice Location Address:

4159 LINDELL BLVD
SAINT LOUIS, MO
63108-2913

Practice Phone: 630-468-1824
Practice Fax:

Directions to “NU-CROWN, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.