Healthcare Provider Details

I. General information

NPI: 1831216068
Provider Name (Legal Business Name): P.M.C.C. HOMEMAKER CHORE SVC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

437 THOMAS AVE
SAINT LOUIS MO
63135-2658
US

IV. Provider business mailing address

437 THOMAS AVE
SAINT LOUIS MO
63135-2658
US

V. Phone/Fax

Practice location:
  • Phone: 314-522-0002
  • Fax: 314-522-0009
Mailing address:
  • Phone: 314-522-0002
  • Fax: 314-522-0009

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: MR. SHADRACH ANTIONE MCGILL
Title or Position: ASSIST. ADMIN.
Credential:
Phone: 314-732-7506