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General NPI Number Information
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NPI Number | 1306060488
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Entity Type | Organization
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Legal Business Name | PHILLIPS PROFESSIONAL HOME HEALTH SERVICE
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 07/11/2008
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Provider Practice Location Address
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Address Line | 8456A PAGE AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63130-1055
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Country | US
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Telephone | 314-423-9596
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Fax | 314-426-1678
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Provider Business Mailing Address
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Address Line | 8456A PAGE AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63130-1055
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Country | US
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Telephone | 314-423-9596
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Fax | 314-426-1678
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Authorized Official
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Title or Position | OWNER
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Name | MS. PEARL FRANK
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Credential |
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Telephone | 314-423-9596
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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 | 0003114
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License Number State | MO
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