| Kidney Wellcare & Counseling Llc | |
|
9666 Olive Blvd Ste 205 Olivette MO 63132-3025 | |
| (614) 425-2604 | |
| Not Available |
| Full Name | Kidney Wellcare & Counseling Llc |
|---|---|
| Speciality | Social Worker |
| Location | 9666 Olive Blvd Ste 205, Olivette, Missouri |
| Authorized Official Name and Position | Barron E Rutledge (CEO/OWNER) |
| Authorized Official Contact | 6144252604 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kidney Wellcare & Counseling Llc 13439 Forestlac Dr Saint Louis MO 63141-6005 Ph: (614) 425-2604 | Kidney Wellcare & Counseling Llc 9666 Olive Blvd Ste 205 Olivette MO 63132-3025 Ph: (614) 425-2604 |
| NPI Number | 1669070892 |
|---|---|
| Provider Enumeration Date | 10/09/2020 |
| Last Update Date | 10/09/2020 |
| Certification Date | 10/09/2020 |
| Medicare PECOS PAC ID | 1355754482 |
|---|---|
| Medicare Enrollment ID | O20210111002410 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669070892 | NPI | - | NPPES |
| Provider Name | Barron E Rutledge |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689229874 PECOS PAC ID: 3173853843 Enrollment ID: I20190923001734 |
| Provider Name | Wendy J Castle |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1841684214 PECOS PAC ID: 1850704974 Enrollment ID: I20210111001608 |
| Provider Name | Cassidy Warne |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1306484209 PECOS PAC ID: 9436554839 Enrollment ID: I20210824000801 |
| Provider Name | Alyssa Fleming |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1619687050 PECOS PAC ID: 5890152334 Enrollment ID: I20230527000285 |
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