Healthcare Provider Details

I. General information

NPI: 1457675167
Provider Name (Legal Business Name): VICTOR'S HOME CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2010
Last Update Date: 03/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8420 DELMAR BLVD STE 507
SAINT LOUIS MO
63124-2170
US

IV. Provider business mailing address

8420 DELMAR BLVD STE 507
SAINT LOUIS MO
63124-2170
US

V. Phone/Fax

Practice location:
  • Phone: 314-872-7749
  • Fax: 314-872-8854
Mailing address:
  • Phone: 314-872-7749
  • Fax: 314-872-8854

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: MR. VICTOR BARINGOLTS
Title or Position: PRESIDENT
Credential:
Phone: 314-872-7749