Individual provider · NPI-1

Derek Anderson

Home Health · Saint Louis, MO

NPI number1497416598
StatusActive
Last updated in NPPESJan 1, 2022

Details

NPI
1497416598
Entity type
Individual (NPI-1)
Name
Derek Anderson
Sex
Male
Sole proprietor
Yes
Enumeration date
Jan 1, 2022
Certification date
Jan 1, 2022
Last updated
Jan 1, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
251E00000X Home Health2010014757MOYes
246ZC0007X Specialist/Technologist, Other, Surgical Assistant2010014757–
332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment2010014757MO
343900000X Non-emergency Medical Transport (VAN)2010014757MO

Practice location

3624 N 14th St
Saint Louis, MO 63107-3703

Phone 314-541-8131

Mailing address

3624 N 14th St
Saint Louis, MO 63107-3703

Phone 314-541-8131

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