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General NPI Number Information
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NPI Number | 1124561469
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Entity Type | Organization
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Legal Business Name | CARDINAL HOME CARE LLC
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Dates
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Enumeration Date | 11/18/2016
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Last Update Date | 11/18/2016
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Provider Practice Location Address
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Address Line | 18 CONVENT GARDEN CT
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City | O'FALLON
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State | MO
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Zip | 63368
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Country | US
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Telephone | 901-351-2648
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Fax |
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Provider Business Mailing Address
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Address Line | 18 CONVENT GARDEN CT
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City | O'FALLON
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State | MO
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Zip | 63368
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Country | US
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Telephone | 901-351-2648
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. VARSHA KANJEE
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Credential |
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Telephone | 901-351-2648
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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 |
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