Organization
DELTA MEDICAL SUPPLY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUNE ELLEN FISCHER (OWNER)
(913) 638-8368
Entity
Organization
Contact information
Practice address
11734 LACKLAND INDUSTRIAL DR, SAINT LOUIS, MO 63146-4209
(314) 423-3165
(314) 423-3143
Mailing address
11734 LACKLAND INDUSTRIAL DR, SAINT LOUIS, MO 63146-4209
(314) 423-3165
(314) 423-3143
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
133460
BC/BS
MO
05
—
625094503
—
MO
Enumeration date
05/28/2006
Last updated
06/10/2021
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