Healthcare Provider Details

I. General information

NPI: 1669594669
Provider Name (Legal Business Name): J. W. H. HEALTHCARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 07/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3530 GREENWOOD BLVD SUITE A
MAPLEWOOD MO
63143-4211
US

IV. Provider business mailing address

3530 GREENWOOD BLVD SUITE A
MAPLEWOOD MO
63143-4211
US

V. Phone/Fax

Practice location:
  • Phone: 314-645-5775
  • Fax: 314-645-1265
Mailing address:
  • Phone: 314-645-5775
  • Fax: 314-645-1265

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number051659
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code163WC1600X
TaxonomyContinuing Education/Staff Development Registered Nurse
License Number051659
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number051659
License Number StateMO
# 4
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number051659
License Number StateMO
# 5
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code163WG0600X
TaxonomyGerontology Registered Nurse
License Number051659
License Number StateMO

VIII. Authorized Official

Name: MS. JOICE L. WESTFALL-HOLLINGSWORTH
Title or Position: EXECUTIVE DIRECTOR
Credential: RN-B
Phone: 314-645-5775