MEDICARE: CARE 4 LIFE MEDICAL RESOURCES, 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	251E00000X	Home Health Agency		MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346342672
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARE 4 LIFE MEDICAL RESOURCES, LLC

Provider Business Mailing Address
First Line	:	4013 7 HILLS DR
Second Line	:
City	:	FLORISSANT
State	:	MO
Zip	:	63033-6737
Country	:	US
Telephone Number	:	314-972-9400
Fax Number	:	314-972-9405

Provider Business Practice Location Address
First Line	:	4013 7 HILLS DR
Second Line	:
City	:	FLORISSANT
State	:	MO
Zip	:	63033-6737
Country	:	US
Telephone Number	:	314-972-9400
Fax Number	:	314-972-9405

Authorized Official
Title or Position	:	OWNER/DIRECTOR
Name	:	MRS. ANTANAIA MILLER
Credential	:
Telephone Number	:	314-355-6207

Provider Enumeration Date	:	09/05/2006
Last Update Date	:	08/22/2020

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