Provider Demographics
NPI:1720393713
Name:SEMO DRUG - CARE PLUS OF MO, INC.
Entity Type:Organization
Organization Name:SEMO DRUG - CARE PLUS OF MO, INC.
Other - Org Name:QUIPT HOME MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:J
Authorized Official - Last Name:CRAWFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-441-8876
Mailing Address - Street 1:1019 TOWN DR
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND HEIGHTS
Mailing Address - State:KY
Mailing Address - Zip Code:41076-9114
Mailing Address - Country:US
Mailing Address - Phone:859-441-8876
Mailing Address - Fax:
Practice Address - Street 1:400 HIGHWAY 49 N STE 1
Practice Address - Street 2:
Practice Address - City:PARAGOULD
Practice Address - State:AR
Practice Address - Zip Code:72450-4026
Practice Address - Country:US
Practice Address - Phone:870-239-5555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-13
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR185260716Medicaid
AR1307820002Medicare NSC