NPIMap

Organization Active NPI

Med Resources Retail, LLC

  • Durable Medical Equipment & Medical Supplies
  • Chesterfield, MO
National Provider Identifier
1235124165
Registry record updated Feb 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
MED RESOURCES RETAIL, LLC
Practice address
15464 Olive Boulevard
Suite 200
Chesterfield, MO 63017-1719
Phone
(636) 530-4500
Fax
(636) 530-4577
NPI assigned
Sep 16, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2021

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

Authorized official

Name
Jeff Braun
Title
Executive Director
Phone
(636) 733-7200

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary
Customized Equipment (DME) 332BC3200X

Addresses

Primary practice location

15464 Olive Boulevard
Suite 200
Chesterfield, MO 63017-1719

Mailing address

15464 Olive Boulevard
Suite 200
Chesterfield, MO 63017-1719
Phone (636) 530-4500

Other identifiers 1

IdentifierTypeStateIssuer
626238505MedicaidMO

Other names 1

  • Med Resources Retail Doing business as

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Member organizations 3

Organizations listed as members of this organization in the National Provider Directory.

Locations

1688 Clarkson Rd
Chesterfield, MO 63017
Phone (636) 530-4500

NPI Registry JSON

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

{
    "created_epoch": "1126828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613606400000",
    "number": "1235124165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15464 OLIVE BOULEVARD",
            "address_2": "SUITE 200",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630171719",
            "telephone_number": "636-530-4500",
            "fax_number": "636-530-4577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15464 OLIVE BOULEVARD",
            "address_2": "SUITE 200",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630171719",
            "telephone_number": "636-530-4500",
            "fax_number": "636-530-4577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED RESOURCES RETAIL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-16",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A",
        "authorized_official_last_name": "BRAUN",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "636-733-7200"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "626238505",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Med Resources Retail",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Med Resources Retail",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chesterfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.