Healthcare Provider Details

I. General information

NPI: 1154331809
Provider Name (Legal Business Name): BJC HOME CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 11/10/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 SOUTH BOYLE AVENUE
SAINT LOUIS MO
63110
US

IV. Provider business mailing address

710 S BOYLE AVE
SAINT LOUIS MO
63110-1630
US

V. Phone/Fax

Practice location:
  • Phone: 314-953-2000
  • Fax: 314-953-2140
Mailing address:
  • Phone: 314-953-2000
  • Fax: 314-953-2140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number203000193
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: ANGELA MARTIN-DAVIS
Title or Position: PRESIDENT
Credential:
Phone: 314-206-3712