Provider Demographics
NPI:1689153082
Name:SEW ST. LOUIS LLC
Entity Type:Organization
Organization Name:SEW ST. LOUIS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CERTIFIEDHAIR LOSS SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:KENDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:COSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-942-9000
Mailing Address - Street 1:2172 N WATERFORD DR
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63033-2301
Mailing Address - Country:US
Mailing Address - Phone:314-942-9000
Mailing Address - Fax:
Practice Address - Street 1:2172 N WATERFORD DR
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63033
Practice Address - Country:US
Practice Address - Phone:314-942-9000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-07
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case ManagementGroup - Single Specialty