Provider Demographics
NPI:1659483162
Name:MEDNET INC.
Entity Type:Organization
Organization Name:MEDNET INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:A
Authorized Official - Last Name:JABLONOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-426-7778
Mailing Address - Street 1:9666 OLIVE BLVD
Mailing Address - Street 2:SUITE 690
Mailing Address - City:OLIVETTE
Mailing Address - State:MO
Mailing Address - Zip Code:63132-3013
Mailing Address - Country:US
Mailing Address - Phone:314-426-7778
Mailing Address - Fax:314-426-7733
Practice Address - Street 1:9666 OLIVE BLVD
Practice Address - Street 2:SUITE 690
Practice Address - City:OLIVETTE
Practice Address - State:MO
Practice Address - Zip Code:63132-3013
Practice Address - Country:US
Practice Address - Phone:314-426-7778
Practice Address - Fax:314-426-7733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO0838640001Medicare ID - Type Unspecified