Provider Demographics
NPI:1518570696
Name:HOME DRS MEDICAL GROUP
Entity Type:Organization
Organization Name:HOME DRS MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-361-7764
Mailing Address - Street 1:7171 DELMAR BLVD
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY CITY
Mailing Address - State:MO
Mailing Address - Zip Code:63130-4341
Mailing Address - Country:US
Mailing Address - Phone:314-361-7764
Mailing Address - Fax:314-361-7776
Practice Address - Street 1:7171 DELMAR BLVD
Practice Address - Street 2:
Practice Address - City:UNIVERSITY CITY
Practice Address - State:MO
Practice Address - Zip Code:63130-4341
Practice Address - Country:US
Practice Address - Phone:314-361-7764
Practice Address - Fax:314-361-7776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No251E00000XAgenciesHome HealthGroup - Multi-Specialty