Healthcare Provider Details

I. General information

NPI: 1104738855
Provider Name (Legal Business Name): TAM AN CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7501 MURDOCS AVE
SAINT LOUIS MO
63119
US

IV. Provider business mailing address

4422 N RAVENSWOOD AVE
CHICAGO IL
60640-5803
US

V. Phone/Fax

Practice location:
  • Phone: 314-208-5842
  • Fax:
Mailing address:
  • Phone: 314-208-5842
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: TRI DU PHAN
Title or Position: OWNER
Credential:
Phone: 314-208-5842