Organization
CARESTL HEALTH #3
Active
Other names
HOMER G PHILLIPS HEALTH CNTR
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANGELA RENEE CLABON (CEO)
(314) 367-5820
Entity
Organization
Contact information
Practice address
2425 WHITTIER ST, SAINT LOUIS, MO 63113-2950
(314) 371-3100
(314) 535-4662
Mailing address
2425 WHITTIER ST, SAINT LOUIS, MO 63113-2950
(314) 371-3100
(314) 535-4662
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
Primary
2005035951
MO
3336M0002X
Mail Order Pharmacy
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2636299
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/14/2006
Last updated
09/14/2020
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