Provider Demographics
NPI:1417252602
Name:MEDCURO MANUFACTURING, LLC
Entity Type:Organization
Organization Name:MEDCURO MANUFACTURING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:J
Authorized Official - Last Name:PAGANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-567-8595
Mailing Address - Street 1:9959 LIN FERRY DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63123-6913
Mailing Address - Country:US
Mailing Address - Phone:314-842-5569
Mailing Address - Fax:314-842-0209
Practice Address - Street 1:9959 LIN FERRY DR
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63123-6913
Practice Address - Country:US
Practice Address - Phone:314-842-5569
Practice Address - Fax:314-842-0209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-19
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment