Provider Demographics
NPI:1588091425
Name:MED RESOURCES, INC.
Entity type:Organization
Organization Name:MED RESOURCES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:HARTMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:636-733-7000
Mailing Address - Street 1:14805 N OUTER 40 RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-6060
Mailing Address - Country:US
Mailing Address - Phone:636-733-7200
Mailing Address - Fax:636-733-7202
Practice Address - Street 1:2350 STATE ST
Practice Address - Street 2:
Practice Address - City:ALTON
Practice Address - State:IL
Practice Address - Zip Code:62002-4319
Practice Address - Country:US
Practice Address - Phone:618-466-5632
Practice Address - Fax:618-466-4642
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MED RESOURCES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-10-10
Last Update Date:2014-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1315150003Medicare NSC