Organization Active NPI

Biotab LLC

  • Durable Medical Equipment & Medical Supplies
  • Saint Louis, MO
National Provider Identifier
1124124953
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
BIOTAB LLC
Doing business as
BioTAB Healthcare
Practice address
11701 Borman Dr Ste 107
Saint Louis, MO 63146-4100
Phone
(877) 246-8220
NPI assigned
Sep 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Authorized official

Name
Mr. Tim Bacich
Title
Owner
Phone
(314) 812-3949

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

11701 Borman Dr Ste 107
Saint Louis, MO 63146-4100

Mailing address

11701 Borman Dr Ste 107
Saint Louis, MO 63146-4100
Phone (877) 246-8220

Other identifiers 1

IdentifierTypeStateIssuer
184836OtherANTHEM BLUE CROSS

Other names 1

  • BioTAB Healthcare Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930029476 MO DME Supplier - Medical Supply Company 8123236205 Practice locations: Saint Louis, MO

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Biotab LLC11701 Borman Dr, Saint Louis, MO 63146-41003148123949145 Pneumatic Compression Devices and/or Supplies Does not accept assignmentParticipating since Jun 7, 2004

National Provider Directory

National Provider Directory
Tax ID family
Biotab LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

501 N Lindbergh Blvd
Ste 107
Saint Louis, MO 63141
Phone (314) 812-3949

11701 Borman Dr
Ste 107
Saint Louis, MO 63146
Phone (877) 246-8220

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749427200000",
    "number": "1124124953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11701 BORMAN DR STE 107",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631464100",
            "telephone_number": "877-246-8220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11701 BORMAN DR STE 107",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631464100",
            "telephone_number": "877-246-8220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIOTAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-16",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A",
        "authorized_official_last_name": "BACICH",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-812-3949",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "184836",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BioTAB Healthcare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BioTAB Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.