Healthcare Provider Details

I. General information

NPI: 1568372415
Provider Name (Legal Business Name): JEREMIAH GILES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1520 S 5TH ST STE 201
SAINT CHARLES MO
63303-4126
US

IV. Provider business mailing address

1520 S 5TH ST STE 201
SAINT CHARLES MO
63303-4126
US

V. Phone/Fax

Practice location:
  • Phone: 636-246-9899
  • Fax:
Mailing address:
  • Phone: 636-246-9899
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: