Carestl Health #4

Primary specialty

Clinic PharmacyTaxonomy code 3336C0002X

License

2016012067 Issued in MO

Legal business name

CARESTL HEALTH #4

Practice address

4500 Pope Ave
Saint Louis, MO 63115

Phone

(314) 385-3990

Fax

(314) 389-2464

NPI assigned

Jun 1, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Angela R Archibald-Clabon, CEO

Title

Chief Executive Officer

Phone

(314) 367-5820

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Carestl Health

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1972596088

  O20200810001517

  Same enrollment
• Carestl Health #1

  dba Myrtle Hilliard Davis Comprehensive

  • Clinic Pharmacy
  • Saint Louis, MO
  • NPI 1972653202

  O20200810001517

  Same enrollment
• Carestl Health #2

  • Clinic Pharmacy
  • Saint Louis, MO
  • NPI 1467494062

  O20200810001517

  Same enrollment
• Carestl Health #3

  dba Homer G Phillips Health CNTR

  • Clinic Pharmacy
  • Saint Louis, MO
  • NPI 1740206697

  O20200810001517

  Same enrollment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1464739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600041600000",
    "number": "1023466984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 POPE AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631152512",
            "telephone_number": "314-385-3990",
            "fax_number": "314-389-2464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 POPE AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "63115",
            "telephone_number": "314-385-3990",
            "fax_number": "314-389-2464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARESTL HEALTH #4",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-01",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A",
        "authorized_official_last_name": "ARCHIBALD-CLABON",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "314-367-5820",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "MO",
            "license": "2016012067",
            "primary": true
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carestl Health
• Carestl Health
• Carestl Health #1 (Myrtle Hilliard Davis Comprehensive)
• Carestl Health #2
• Carestl Health #3 (Homer G Phillips Health CNTR)
• Stephen Carew
• Abigail G Carey-Ewend
• Andrea Carey, DPT
• Ashley Carey, DO
• Charles F Carey, M.D.

• Clinic Pharmacy in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Clinic Pharmacy in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.