MEDICARE: SPECIALTY HOME HEALTHCARE INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251E00000X	Home Health Agency
2	251F00000X	Home Infusion Agency
3	251J00000X	Nursing Care Agency
4	253Z00000X	In Home Supportive Care Agency
5	372500000X	Chore Provider
6	376J00000X	Homemaker
7	385H00000X	Respite Care
8	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1083110647
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPECIALTY HOME HEALTHCARE INC.

Provider Business Mailing Address
First Line	:	PO BOX 410181
Second Line	:
City	:	CREVE COEUR
State	:	MO
Zip	:	63141-0181
Country	:	US
Telephone Number	:	314-712-6170
Fax Number	:

Provider Business Practice Location Address
First Line	:	2012 WOODSON RD STE D
Second Line	:
City	:	OVERLAND
State	:	MO
Zip	:	63114-5644
Country	:	US
Telephone Number	:	314-222-9521
Fax Number	:	636-220-8379

Authorized Official
Title or Position	:	OWNER/EXECUTIVE DIRECTOR
Name	:	LONNIKAH HOLMES
Credential	:
Telephone Number	:	314-368-4207

Provider Enumeration Date	:	04/03/2018
Last Update Date	:	10/30/2023

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