MEDICARE: OUR HANDS THAT CARE IHS 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	305R00000X	Preferred Provider Organization

General Provider Information

NPI Number	:	1700242872
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OUR HANDS THAT CARE IHS LLC

Provider Business Mailing Address
First Line	:	4144 LINDELL BLVD STE 312A
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63108-2953
Country	:	US
Telephone Number	:	314-361-2178
Fax Number	:	844-274-1077

Provider Business Practice Location Address
First Line	:	4144 LINDELL BLVD STE 312A
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63108-2953
Country	:	US
Telephone Number	:	314-361-2178
Fax Number	:	844-274-1077

Authorized Official
Title or Position	:	OWNER
Name	:	MS. JOYCE NICOLE DAVIS
Credential	:
Telephone Number	:	314-361-2178

Provider Enumeration Date	:	01/05/2016
Last Update Date	:	01/05/2016

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Directions to “OUR HANDS THAT CARE IHS LLC ” Practice Location

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