Organization
MEDICAL WEST HEALTHCARE CENTER LLC
Active
Other names
Quipt Home Medical Clayton
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY J CRAWFORD (CEO)
(859) 441-8876
Entity
Organization
Contact information
Practice address
444 S BRENTWOOD BLVD, CLAYTON, MO 63105-2521
(314) 725-1888
(314) 725-1444
Mailing address
1019 TOWN DR, HIGHLAND HEIGHTS, KY 41076-9114
(859) 441-8876
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
MO
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
18411550
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
181658
BLUE CROSS BLUE SHIELD
MO
01
—
612829
HEALTHLINK
MO
05
—
626100101
—
MO
Enumeration date
11/19/2013
Last updated
05/21/2024
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