Healthcare Provider Details

I. General information

NPI: 1720934870
Provider Name (Legal Business Name): FRONTLINE HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2026
Last Update Date: 03/09/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3313 E 113TH TER APT B
KANSAS CITY MO
64137-2260
US

IV. Provider business mailing address

701 MARKET ST STE 110
SAINT LOUIS MO
63101-1824
US

V. Phone/Fax

Practice location:
  • Phone: 314-806-4817
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: FADUMO AHMED
Title or Position: AUTHORIZED AGENT
Credential: AHMED
Phone: 314-806-4817