MEDICARE: LORY'S LOVING CARE 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	617983	MO

General Provider Information

NPI Number	:	1982146478
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LORY'S LOVING CARE LLC

Provider Business Mailing Address
First Line	:	1408 N KINGSHIGHWAY BLVD
Second Line	:	103A
City	:	SAINT LOUIS
State	:	MO
Zip	:	63113-1400
Country	:	US
Telephone Number	:	314-665-6361
Fax Number	:	844-270-4775

Provider Business Practice Location Address
First Line	:	1408 N KINGSHIGHWAY BLVD
Second Line	:	103A
City	:	SAINT LOUIS
State	:	MO
Zip	:	63113-1400
Country	:	US
Telephone Number	:	314-665-6361
Fax Number	:	844-270-4775

Authorized Official
Title or Position	:	OWNER
Name	:	LORY CURRY
Credential	:
Telephone Number	:	314-665-6361

Provider Enumeration Date	:	11/15/2016
Last Update Date	:	11/15/2016

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