MEDICARE: QUALITY HOME HEALTHCARE SERVICES 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

General Provider Information

NPI Number	:	1437403714
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUALITY HOME HEALTHCARE SERVICES LLC

Provider Business Mailing Address
First Line	:	5740 GREER AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63120-1607
Country	:	US
Telephone Number	:	314-458-5317
Fax Number	:	618-875-7004

Provider Business Practice Location Address
First Line	:	5740 GREER AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63120-1607
Country	:	US
Telephone Number	:	314-458-5317
Fax Number	:	618-875-7004

Authorized Official
Title or Position	:	MANAGER
Name	:	CARLA DENISE KENNEDY
Credential	:
Telephone Number	:	314-458-5317

Provider Enumeration Date	:	11/07/2012
Last Update Date	:	11/07/2012

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