Provider Demographics
NPI:1114057775
Name:MLC VENTURES
Entity Type:Organization
Organization Name:MLC VENTURES
Other - Org Name:ADVANCED THERAPUETICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT-CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:EMT-P
Authorized Official - Phone:314-630-7651
Mailing Address - Street 1:7127 MEXICO RD
Mailing Address - Street 2:SUITE 226
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-5400
Mailing Address - Country:US
Mailing Address - Phone:314-630-7651
Mailing Address - Fax:636-332-3317
Practice Address - Street 1:7127 MEXICO RD
Practice Address - Street 2:SUITE 226
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-5400
Practice Address - Country:US
Practice Address - Phone:314-630-7651
Practice Address - Fax:636-332-3317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies