Provider Demographics
NPI:1831256049
Name:CLOVER CARE LLC
Entity type:Organization
Organization Name:CLOVER CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:L
Authorized Official - Last Name:SCHEIBLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-423-7400
Mailing Address - Street 1:10764 INDIAN HEAD INDUSTRIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63132-1102
Mailing Address - Country:US
Mailing Address - Phone:314-423-7400
Mailing Address - Fax:314-423-7407
Practice Address - Street 1:10764 INDIAN HEAD INDUSTRIAL BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63132-1102
Practice Address - Country:US
Practice Address - Phone:314-423-7400
Practice Address - Fax:314-423-7407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO626312409Medicaid
MO626312409Medicaid