Healthcare Provider Details

I. General information

NPI: 1528533049
Provider Name (Legal Business Name): VETERANS HOME CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2018
Last Update Date: 10/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11861 WESTLINE INDUSTRIAL DRIVE SUITE 750
ST. LOUIS MO
63146
US

IV. Provider business mailing address

11861 WESTLINE INDUSTRIAL DRIVE SUITE 750
ST. LOUIS MO
63146
US

V. Phone/Fax

Practice location:
  • Phone: 314-514-2444
  • Fax: 800-640-7988
Mailing address:
  • Phone: 314-514-2444
  • Fax: 800-640-7988

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: MRS. BONNIE SUE LAIDERMAN
Title or Position: CEO
Credential:
Phone: 314-514-2444