Organization
NEW BALANCE ST.LOUIS
Active
Parent organization
BROWN'S ENTERPRISES INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
BROWN'S ENTERPRISES INC
Authorized official
MR. JERRY LEE COOK CPED. (CERTIFIED PEDORTHIST)
(314) 872-2929
Entity
Organization
Contact information
Practice address
11633 OLIVE BLVD, SAINT LOUIS, MO 63141-7001
(314) 872-2929
(314) 872-2926
Mailing address
11633 OLIVE BLVD, SAINT LOUIS, MO 63141-7001
(314) 872-2929
(314) 872-2926
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
B00029005
MO
332BC3200X
Customized Equipment (DME)
Primary
B00029005
MO
Other
Enumeration date
01/22/2009
Last updated
05/19/2010
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