Healthcare Provider Details

I. General information

NPI: 1578084315
Provider Name (Legal Business Name): HILLTOP HOME HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2017
Last Update Date: 07/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1360 S 5TH ST STE 200
SAINT CHARLES MO
63301-2446
US

IV. Provider business mailing address

PO BOX 410072
SAINT LOUIS MO
63141-0072
US

V. Phone/Fax

Practice location:
  • Phone: 314-283-6084
  • Fax:
Mailing address:
  • Phone: 314-283-6084
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: JASON RILEY
Title or Position: PRESIDENT
Credential:
Phone: 314-283-6084