Provider Demographics
NPI:1518571041
Name:1 WAY HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:1 WAY HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BONNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-330-3073
Mailing Address - Street 1:3751 PENNRIDGE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:BRIDGETON
Mailing Address - State:MO
Mailing Address - Zip Code:63044-1244
Mailing Address - Country:US
Mailing Address - Phone:314-330-3073
Mailing Address - Fax:
Practice Address - Street 1:3751 PENNRIDGE DR STE 100
Practice Address - Street 2:
Practice Address - City:BRIDGETON
Practice Address - State:MO
Practice Address - Zip Code:63044-1244
Practice Address - Country:US
Practice Address - Phone:314-330-3073
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-02
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health