MEDICARE: PAVILION HEALTH COMPANY, 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

General Provider Information

NPI Number	:	1306796073
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAVILION HEALTH COMPANY, LLC

Provider Business Mailing Address
First Line	:	11520 SAINT CHARLES ROCK RD STE 105A
Second Line	:
City	:	BRIDGETON
State	:	MO
Zip	:	63044-2732
Country	:	US
Telephone Number	:	314-402-7432
Fax Number	:

Provider Business Practice Location Address
First Line	:	11520 SAINT CHARLES ROCK RD STE 105A
Second Line	:
City	:	BRIDGETON
State	:	MO
Zip	:	63044-2732
Country	:	US
Telephone Number	:	314-402-7432
Fax Number	:

Authorized Official
Title or Position	:	OWNER/DIRECTOR
Name	:	NAGARAJ V KUNDA
Credential	:
Telephone Number	:	314-312-5588

Provider Enumeration Date	:	02/02/2026
Last Update Date	:	02/02/2026

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Directions to “PAVILION HEALTH COMPANY, LLC ” Practice Location

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