Provider Demographics
NPI:1497185086
Name:MENESY MEDICAL LLC
Entity Type:Organization
Organization Name:MENESY MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NEEKA
Authorized Official - Middle Name:N
Authorized Official - Last Name:MENEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-638-3333
Mailing Address - Street 1:1003 LEMAY FERRY RD UNIT B
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63125-1745
Mailing Address - Country:US
Mailing Address - Phone:314-536-3754
Mailing Address - Fax:314-329-3335
Practice Address - Street 1:1003 LEMAY FERRY RD UNIT B
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63125-1745
Practice Address - Country:US
Practice Address - Phone:314-638-3333
Practice Address - Fax:314-329-3335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-18
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1811294937Medicaid