MEDICARE: MH HEALTH CARE SERVICES, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center
2	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1013479716
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MH HEALTH CARE SERVICES, PC

Provider Business Mailing Address
First Line	:	1403 HAMPTON AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63139-3115
Country	:	US
Telephone Number	:	314-955-2179
Fax Number	:	314-955-2180

Provider Business Practice Location Address
First Line	:	1403 HAMPTON AVENUE
Second Line	:
City	:	ST. LOUIS
State	:	MO
Zip	:	63139
Country	:	US
Telephone Number	:	314-955-9355
Fax Number	:

Authorized Official
Title or Position	:	MANAGER CENTRAL SUPPORT
Name	:	CHARLES VAN EVERY
Credential	:
Telephone Number	:	408-406-9646

Provider Enumeration Date	:	04/02/2019
Last Update Date	:	06/02/2026

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