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General NPI Number Information
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NPI Number | 1609360742
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Entity Type | Organization
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Legal Business Name | ABC HOME HEALTH
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Dates
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Enumeration Date | 06/21/2018
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Last Update Date | 05/12/2020
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Provider Practice Location Address
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Address Line | 1100 LA ROUX CT
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City | SAINT LOUIS
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State | MO
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Zip | 63137-1837
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Country | US
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Telephone | 314-303-6583
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Fax |
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Provider Business Mailing Address
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Address Line | 1100 LA ROUX CT
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City | SAINT LOUIS
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State | MO
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Zip | 63137-1837
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Country | US
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Telephone | 314-303-6583
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CYNTHIA ANN GILLESPIE
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Credential |
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Telephone | 314-303-6583
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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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