1760540538 NPI number — RESIDENTIAL SERVICES CORPORATION

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 1760540538 NPI number — RESIDENTIAL SERVICES CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RESIDENTIAL SERVICES CORPORATION
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:
6
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:
1760540538
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/04/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7301 WATSON RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAINT LOUIS
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63119-4405
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
314-961-8000
Provider Business Mailing Address Fax Number:
314-423-4842

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10441 INTERNATIONAL PLAZA DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ST ANN
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63074
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
314-423-0600
Provider Business Practice Location Address Fax Number:
314-423-4842
Provider Enumeration Date:
12/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BONNESS
Authorized Official First Name:
JACQUELINE
Authorized Official Middle Name:
J
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
314-961-8000

Provider Taxonomy Codes

  • Taxonomy code: 310400000X , with the licence number:  032705 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 269980207 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".




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