1659415008 NPI number — DRS. MERA, BOESCH & KUMAR, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659415008 NPI number — DRS. MERA, BOESCH & KUMAR, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DRS. MERA, BOESCH & KUMAR, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1659415008
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/26/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
232 S WOODS MILL RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHESTERFIELD
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63017-3417
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
636-685-7804
Provider Business Mailing Address Fax Number:
314-576-2344

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
222 S WOODS MILL RD STE 630N
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHESTERFIELD
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63017-3645
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
636-685-7727
Provider Business Practice Location Address Fax Number:
314-590-5919
Provider Enumeration Date:
02/19/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SNIDER
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
Authorized Official Title or Position:
V. P. PHYSICIAN NETWORK
Authorized Official Telephone Number:
636-685-7804

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: DD6753 . This is a "RR MEDICARE" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".




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