Organization
GREAT PROVIDERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALICE FERN MCBRIDE (LLC OWNER)
(314) 397-8576
Entity
Organization
Contact information
Practice address
3466 BRIDGELAND DR STE 202, BRIDGETON, MO 63044-2606
(314) 397-8576
Mailing address
3466 BRIDGELAND DR STE 202, BRIDGETON, MO 63044-2606
(314) 397-8576
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
04/10/2018
Last updated
04/10/2018
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