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General NPI Number Information
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NPI Number | 1003799057
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Entity Type | Organization
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Legal Business Name | POWER UP HOME CARE, LLC
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Dates
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Enumeration Date | 07/28/2025
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 4887 BESSIE AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63115-2143
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Country | US
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Telephone | 314-435-9625
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Fax |
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Provider Business Mailing Address
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Address Line | 4887 BESSIE AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63115-2143
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Country | US
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Telephone | 314-435-9625
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Fax |
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Authorized Official
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Title or Position | MEMBER /MANAGER
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Name | ANNETTA POOL
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Credential |
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Telephone | 314-435-9625
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174200000X
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Taxonomy Name | Meals Provider
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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