Provider Demographics
NPI:1588651384
Name:MEDICAL SPECIALTIES, INC.
Entity Type:Organization
Organization Name:MEDICAL SPECIALTIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:H
Authorized Official - Last Name:SCHILLIGO
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:636-561-4444
Mailing Address - Street 1:8656 ORF ROAD
Mailing Address - Street 2:
Mailing Address - City:LAKE ST LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63367
Mailing Address - Country:US
Mailing Address - Phone:636-561-4444
Mailing Address - Fax:636-561-4493
Practice Address - Street 1:8656 ORF ROAD
Practice Address - Street 2:
Practice Address - City:LAKE ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63367
Practice Address - Country:US
Practice Address - Phone:636-561-4444
Practice Address - Fax:636-561-4493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO18519971332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO4992660001Medicare ID - Type Unspecified