Active NPI
Orise Distribution LLC
- Durable Medical Equipment & Medical Supplies
- Saint Louis, MO
National Provider Identifier
1477307296
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- Legal business name
- ORISE DISTRIBUTION LLC
- Practice address
- 935 N Vandeventer Ave # 114
Saint Louis, MO 63108-3563 - Phone
- (314) 324-9206
- NPI assigned
- Apr 17, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Quentin T Womack
- Title
- Ceo
- Phone
- (314) 324-9206
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | Primary |
Addresses
Primary practice location
935 N Vandeventer Ave # 114
Saint Louis, MO 63108-3563
Mailing address
935 N Vandeventer Ave # 114
Saint Louis, MO 63108-3563
Phone (314) 324-9206
National Provider Directory
National Provider DirectoryLocations
935 N Vandeventer Ave
#114
Saint Louis, MO 63108
Phone (314) 324-9206
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1713312000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1713312000000",
"number": "1477307296",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "935 N VANDEVENTER AVE # 114",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631083563",
"telephone_number": "314-324-9206"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "935 N VANDEVENTER AVE # 114",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631083563",
"telephone_number": "314-324-9206"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ORISE DISTRIBUTION LLC",
"organizational_subpart": "NO",
"enumeration_date": "2024-04-17",
"last_updated": "2024-04-17",
"certification_date": "2024-04-16",
"status": "A",
"authorized_official_last_name": "WOMACK",
"authorized_official_first_name": "QUENTIN",
"authorized_official_middle_name": "T",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "314-324-9206"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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 Apr 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.