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NPI Code Detail

MEDICARE: COOPERATIVE HOME CARE

MEDICARE: COOPERATIVE HOME CARE
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
1251E00000XHome Health Agency0001287MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1043369473
Entity Type Code : Organization
Provider Name (Legal Business Name) : COOPERATIVE HOME CARE
Provider Business Mailing Address
First Line : 1924 MARCONI AVE
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63110-3038
Country : US
Telephone Number : 314-772-8585
Fax Number : 314-772-2820
Provider Business Practice Location Address
First Line : 1924 MARCONI AVE
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63110-3038
Country : US
Telephone Number : 314-772-8585
Fax Number : 314-772-2820
Authorized Official
Title or Position : CEO & OWNER
Name : MITCH I WAKS
Credential :
Telephone Number : 314-772-8585
Provider Enumeration Date : 01/08/2007
Last Update Date : 03/26/2019

Similar Medicare Providers

1467437475 — COOPERATIVE HOME CARE, INC.
Practice Location Address:
1924 MARCONI AVE
SAINT LOUIS, MO
63110-3038
Practice Phone: 314-776-2336
Practice Fax: 314-865-4418
1659491959 — COOPERATIVE HOME CARE
Practice Location Address:
1924 MARCONI AVE
SAINT LOUIS, MO
63110-3038
Practice Phone: 314-772-8585
Practice Fax: 314-772-2820
1831219138 — COOPERATIVE HOME CARE, INC.
Practice Location Address:
1924 MARCONI AVE
SAINT LOUIS, MO
63110-3038
Practice Phone: 314-772-8585
Practice Fax: 314-772-2820
1740300045 — COOPERATIVE HOME CARE
Practice Location Address:
1924 MARCONI AVE
SAINT LOUIS, MO
63110-3038
Practice Phone: 314-772-8585
Practice Fax: 314-772-2820
1073980504 — COOPERATIVE HOME CARE INC.
Practice Location Address:
1924 MARCONI AVE , 1924 MARCONI AVENUE
SAINT LOUIS, MO
63110-3038
Practice Phone: 314-571-7855
Practice Fax: 314-667-3110
1003372590 — COOPERATIVE HOME CARE, INC.
Practice Location Address:
1924 MARCONI AVE
SAINT LOUIS, MO
63110-3038
Practice Phone: 314-779-9900
Practice Fax: 314-772-2820

Directions to “COOPERATIVE HOME CARE ” Practice Location

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