MEDICARE: OH SO GOOD IN-HOME SERVICES

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	:	1912736919
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OH SO GOOD IN-HOME SERVICES

Provider Business Mailing Address
First Line	:	11116 S TOWNE SQ STE 304
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63123-7809
Country	:	US
Telephone Number	:	314-200-9628
Fax Number	:	314-200-9680

Provider Business Practice Location Address
First Line	:	11116 S TOWNE SQ STE 304
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63123-7809
Country	:	US
Telephone Number	:	314-200-9628
Fax Number	:	314-200-9680

Authorized Official
Title or Position	:	CEO
Name	:	LASHONDA LEWIS
Credential	:
Telephone Number	:	314-200-9628

Provider Enumeration Date	:	07/29/2024
Last Update Date	:	07/29/2024

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Directions to “OH SO GOOD IN-HOME SERVICES ” Practice Location

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