Provider Demographics
NPI:1952458655
Name:DEPENDACARE MEDICAL EQUIPMENT INC.
Entity Type:Organization
Organization Name:DEPENDACARE MEDICAL EQUIPMENT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:A
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:636-937-0400
Mailing Address - Street 1:28 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FESTUS
Mailing Address - State:MO
Mailing Address - Zip Code:63028-1903
Mailing Address - Country:US
Mailing Address - Phone:636-937-0400
Mailing Address - Fax:636-931-0889
Practice Address - Street 1:28 E MAIN ST
Practice Address - Street 2:
Practice Address - City:FESTUS
Practice Address - State:MO
Practice Address - Zip Code:63028-1903
Practice Address - Country:US
Practice Address - Phone:636-937-0400
Practice Address - Fax:636-931-0889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO0438190001Medicare ID - Type Unspecified