Provider Demographics
NPI:1649584061
Name:SCOTT MEDICAL
Entity type:Organization
Organization Name:SCOTT MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:KREBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-757-8655
Mailing Address - Street 1:200 WOODLAND PLACE CT
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63303-6588
Mailing Address - Country:US
Mailing Address - Phone:314-757-8655
Mailing Address - Fax:805-482-7940
Practice Address - Street 1:200 WOODLAND PLACE CT
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63303-6588
Practice Address - Country:US
Practice Address - Phone:314-757-8655
Practice Address - Fax:805-482-7940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-27
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies