1790796209 NPI number — UNITY HEALTH MEDSCRIPT INC

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 1790796209 NPI number — UNITY HEALTH MEDSCRIPT INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNITY HEALTH MEDSCRIPT INC
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:
MEDSCRIPT SERVICE
Provider Other Organization Name Type Code:
3
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:
1790796209
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 504207
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:
63150-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13185 LAKEFRONT DR
Provider Second Line Business Practice Location Address:
STE 100
Provider Business Practice Location Address City Name:
EARTH CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63045-1510
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
314-506-6066
Provider Business Practice Location Address Fax Number:
314-506-6067
Provider Enumeration Date:
08/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CARUSO
Authorized Official First Name:
DOMINIC
Authorized Official Middle Name:
Authorized Official Title or Position:
DIR OF PHCY OPS
Authorized Official Telephone Number:
314-506-6069

Provider Taxonomy Codes

  • Taxonomy code: 333600000X , with the licence number:  2000175014 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 3336L0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 3336M0002X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 3336S0011X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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

  • Identifier: 2604230 . This is a "OTHER ID NUMBER-COMMERCIAL NUMBER" identifier . This identifiers is of the category "OTHER".




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