MEDICARE: ANGEL AID 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	253Z00000X	In Home Supportive Care Agency	LC0944164	MO

General Provider Information

NPI Number	:	1881835072
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANGEL AID LLC

Provider Business Mailing Address
First Line	:	3509 OXFORD BLVD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63143-4208
Country	:	US
Telephone Number	:	314-414-9000
Fax Number	:	314-414-9000

Provider Business Practice Location Address
First Line	:	3509 OXFORD BLVD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63143-4208
Country	:	US
Telephone Number	:	314-414-9000
Fax Number	:	314-414-9000

Authorized Official
Title or Position	:	MANAGER/REGISTERED NURSE
Name	:	MS. KATHLEEN A COPPLE
Credential	:	R.N.
Telephone Number	:	314-374-0116

Provider Enumeration Date	:	03/17/2009
Last Update Date	:	03/17/2009

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Directions to “ANGEL AID LLC ” Practice Location

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