Healthcare Provider Details

I. General information

NPI: 1063180396
Provider Name (Legal Business Name): BJC HOME CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2021
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

670 MASON RIDGE CENTER DR STE 300
SAINT LOUIS MO
63141-8573
US

IV. Provider business mailing address

670 MASON RIDGE CENTER DR STE 300
SAINT LOUIS MO
63141-8573
US

V. Phone/Fax

Practice location:
  • Phone: 314-953-2000
  • Fax:
Mailing address:
  • Phone: 314-953-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: SUSANNE MARIE ROSENBERG
Title or Position: VICE PRESIDENT
Credential:
Phone: 314-699-3432