Provider Demographics
NPI:1679011597
Name:A-3 CDS LLC
Entity type:Organization
Organization Name:A-3 CDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANGER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:CROFT
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:314-932-1461
Mailing Address - Street 1:7500 W FLORISSANT AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63136-1342
Mailing Address - Country:US
Mailing Address - Phone:314-932-1461
Mailing Address - Fax:314-932-1462
Practice Address - Street 1:7500 W FLORISSANT AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63136-1342
Practice Address - Country:US
Practice Address - Phone:314-932-1461
Practice Address - Fax:314-932-1462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-11
Last Update Date:2017-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health