Organization
CARESTL HEALTH #2
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANGELA RENEE CLABON (CHIEF EXECUTIVE OFFICER)
(314) 367-5820
Entity
Organization
Contact information
Practice address
5541 RIVERVIEW BLVD, SAINT LOUIS, MO 63120
(314) 389-4566
(314) 382-0263
Mailing address
5541 RIVERVIEW BLVD, SAINT LOUIS, MO 63120-2443
(314) 389-4566
(314) 389-5514
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
Primary
2005035950
MO
3336M0002X
Mail Order Pharmacy
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2049138
PK
—
Enumeration date
06/11/2006
Last updated
09/14/2020
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