Healthcare Provider Details

I. General information

NPI: 1831998293
Provider Name (Legal Business Name): BJC HOME CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2025
Last Update Date: 03/10/2025
Certification Date: 03/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1040 N MASON RD STE 120
SAINT LOUIS MO
63141-6361
US

IV. Provider business mailing address

4249 CLAYTON AVE
SAINT LOUIS MO
63110-1718
US

V. Phone/Fax

Practice location:
  • Phone: 314-953-2000
  • Fax: 314-953-2158
Mailing address:
  • Phone: 314-953-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: ANGELA MARTIN-DAVIS
Title or Position: PRESIDENT
Credential:
Phone: 253-951-7371