MEDICARE: DOUBLE D INVESTMENT GROUP, 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

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	:	1497195929
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOUBLE D INVESTMENT GROUP, LLC

Provider Business Mailing Address
First Line	:	1409 WASHINGTON AVE
Second Line	:	SUITE 203
City	:	SAINT LOUIS
State	:	MO
Zip	:	63103-1936
Country	:	US
Telephone Number	:	314-241-1210
Fax Number	:	314-241-1248

Provider Business Practice Location Address
First Line	:	1409 WASHINGTON AVE
Second Line	:	SUITE 203
City	:	SAINT LOUIS
State	:	MO
Zip	:	63103-1936
Country	:	US
Telephone Number	:	314-241-1210
Fax Number	:	314-241-1248

Authorized Official
Title or Position	:	OWNER
Name	:	JOYCE SULLIVAN HOWZE
Credential	:
Telephone Number	:	314-241-1210

Provider Enumeration Date	:	06/28/2013
Last Update Date	:	06/28/2013

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