MEDICARE: PARAMOUNT HEALTH CARE LLC

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	251E00000X	Home Health Agency		MO

General Provider Information

NPI Number	:	1124485842
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PARAMOUNT HEALTH CARE LLC

Provider Business Mailing Address
First Line	:	1409 WASHINGTON AVE
Second Line	:	SUITE 221
City	:	SAINT LOUIS
State	:	MO
Zip	:	63103-1936
Country	:	US
Telephone Number	:	314-629-5355
Fax Number	:	314-344-5003

Provider Business Practice Location Address
First Line	:	1409 WASHINGTON AVE
Second Line	:	SUITE 221
City	:	SAINT LOUIS
State	:	MO
Zip	:	63103-1936
Country	:	US
Telephone Number	:	314-629-5355
Fax Number	:	314-344-5003

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. JOVAN DURRELL WILLIAMS
Credential	:
Telephone Number	:	314-629-5355

Provider Enumeration Date	:	01/26/2016
Last Update Date	:	01/26/2016

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