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General NPI Number Information
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NPI Number | 1063926558
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Entity Type | Organization
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Legal Business Name | MAXCO HOME HEALTH CARE LLC
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Dates
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Enumeration Date | 11/20/2017
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 4144 LINDELL BLVD STE 219
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City | SAINT LOUIS
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State | MO
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Zip | 63108-2932
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Country | US
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Telephone | 314-267-0363
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Fax | 314-261-9515
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Provider Business Mailing Address
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Address Line | 4144 LINDELL BLVD STE 219
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City | SAINT LOUIS
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State | MO
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Zip | 63108-2932
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Country | US
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Telephone | 314-267-0363
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Fax | 314-261-9515
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Authorized Official
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Title or Position | DIRECTOR/CEO
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Name | MS. SHARONA MCCLENDON
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Credential |
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Telephone | 314-267-0363
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | MO
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