MEDICARE: PEACE HARMONY & DIGNITY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WH1000X	Hospice Registered Nurse

General Provider Information

NPI Number	:	1336868504
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEACE HARMONY & DIGNITY LLC

Provider Business Mailing Address
First Line	:	2788 CEDAR GROVE DR
Second Line	:
City	:	BELLEVILLE
State	:	IL
Zip	:	62221-7412
Country	:	US
Telephone Number	:	618-530-6294
Fax Number	:

Provider Business Practice Location Address
First Line	:	2788 CEDAR GROVE DR
Second Line	:
City	:	BELLEVILLE
State	:	IL
Zip	:	62221-7412
Country	:	US
Telephone Number	:	618-530-6294
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	AMBER LYNN GALLOWAY
Credential	:
Telephone Number	:	618-530-6294

Provider Enumeration Date	:	08/23/2022
Last Update Date	:	08/23/2022

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Directions to “PEACE HARMONY & DIGNITY LLC ” Practice Location

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