Provider Demographics
NPI:1700040896
Name:PEDS' NEEDS INC
Entity Type:Organization
Organization Name:PEDS' NEEDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO/VP
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTUAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:HALL
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:314-621-5900
Mailing Address - Street 1:1624 DELMAR BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63103-1808
Mailing Address - Country:US
Mailing Address - Phone:314-621-5900
Mailing Address - Fax:314-621-5266
Practice Address - Street 1:1624 DELMAR BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63103-1808
Practice Address - Country:US
Practice Address - Phone:314-621-5900
Practice Address - Fax:314-621-5266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-17
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOJ208327004332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies