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NPI Code Detail

MEDICARE: BI-STATE HOME HEALTH, INC.

MEDICARE: BI-STATE HOME HEALTH, INC.
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 Agency1010313IL

General Provider Information

NPI Number : 1477544310
Entity Type Code : Organization
Provider Name (Legal Business Name) : BI-STATE HOME HEALTH, INC.
Provider Business Mailing Address
First Line : 430 REGENCY CTR
Second Line :
City : COLLINSVILLE
State : IL
Zip : 62234-4659
Country : US
Telephone Number : 618-343-0325
Fax Number : 618-343-0314
Provider Business Practice Location Address
First Line : 430 REGENCY CTR
Second Line :
City : COLLINSVILLE
State : IL
Zip : 62234-4659
Country : US
Telephone Number : 618-343-0325
Fax Number : 618-343-0314
Authorized Official
Title or Position : OWNER
Name : MR. RICH R HARL
Credential :
Telephone Number : 314-398-7285
Provider Enumeration Date : 10/31/2005
Last Update Date : 08/22/2020

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Directions to “BI-STATE HOME HEALTH, INC. ” Practice Location

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