Provider Demographics
NPI:1073112868
Name:KB CDS HEALTH SERVICES
Entity Type:Organization
Organization Name:KB CDS HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BEARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-814-1398
Mailing Address - Street 1:5431 CHIPPEWA ST UNIT B103
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63109-1635
Mailing Address - Country:US
Mailing Address - Phone:314-685-8859
Mailing Address - Fax:314-754-2671
Practice Address - Street 1:5431 CHIPPEWA ST UNIT B103
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63109-1635
Practice Address - Country:US
Practice Address - Phone:314-685-8859
Practice Address - Fax:314-754-2671
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-22
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care