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General NPI Number Information
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NPI Number | 1811680002
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Entity Type | Organization
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Legal Business Name | BJC HOME CARE SERVICES
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Dates
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Enumeration Date | 06/01/2023
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Last Update Date | 05/22/2024
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Provider Practice Location Address
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Address Line | 4600 MEMORIAL DR
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City | BELLEVILLE
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State | IL
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Zip | 62226-5368
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Country | US
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Telephone | 314-953-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 670 MASON RIDGE CENTER DR STE 300
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City | SAINT LOUIS
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State | MO
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Zip | 63141-8573
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANGELA MARTIN-DAVIS
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Credential |
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Telephone | 314-206-3712
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State |
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