MEDICARE: EXCEL HOME CARE, 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
1	251E00000X	Home Health Agency	855173308	MO

Other Identifiers

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

General Provider Information

NPI Number	:	1487712774
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EXCEL HOME CARE, INC.

Provider Business Mailing Address
First Line	:	10845 OLIVE BLVD STE 165
Second Line	:
City	:	CREVE COEUR
State	:	MO
Zip	:	63141-7760
Country	:	US
Telephone Number	:	314-991-3689
Fax Number	:	314-991-3750

Provider Business Practice Location Address
First Line	:	10845 OLIVE BLVD STE 165
Second Line	:
City	:	CREVE COEUR
State	:	MO
Zip	:	63141-7760
Country	:	US
Telephone Number	:	314-991-3689
Fax Number	:	314-991-3750

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. ILYA EYDELMAN
Credential	:
Telephone Number	:	314-991-3689

Provider Enumeration Date	:	12/05/2006
Last Update Date	:	10/10/2024

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Directions to “EXCEL HOME CARE, INC. ” Practice Location

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