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Organization
SUPPORT SURFACES, INC
Active
Organization
SUPPORT SURFACES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD LISTON (OWNER/CFO)
(314) 890-9900
Entity
Organization
Contact information
Practice address
10770 MIDWEST INDUSTRIAL BLVD, SAINT LOUIS, MO 63132-1610
(314) 426-2747
(314) 428-5500
Mailing address
10770 MIDWEST INDUSTRIAL BLVD, SAINT LOUIS, MO 63132-1610
(314) 426-2747
(314) 428-5500
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
105353
BLUE CROSS BLUE SHIELD
MO
01
—
118374
HEALTHLINK INSURANCE
MO
01
—
33534
GHP INSURANCE
MO
01
—
8655
HEALTHCARE USA
MO
Enumeration date
06/23/2005
Last updated
04/20/2008
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