Organization
MEDICAL WEST RESPIRATORY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL K LANE JR. (DIRECTOR)
(314) 993-8100
Entity
Organization
Contact information
Practice address
1447 US HIGHWAY 61, SUITE C, CRYSTAL CITY, MO 63019
(636) 937-7448
Mailing address
9301 DIELMAN INDUSTRIAL DR, SAINT LOUIS, MO 63132-2204
(314) 993-8100
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
18411550
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1024042
ANCILLARY CARE MGT
MO
01
—
1616644634MED
MERCY HEALTH PLAN
MO
01
—
181658
BLUECROSS BLUE SHIELD MO
MO
01
—
612829
HEALTHLINK
MO
Enumeration date
09/28/2006
Last updated
10/25/2007
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