MEDICARE: I CARE WE CARE HOME 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

General Provider Information

NPI Number	:	1518525120
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	I CARE WE CARE HOME CARE, LLC

Provider Business Mailing Address
First Line	:	8522 OLIVE BLVD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63132-2818
Country	:	US
Telephone Number	:	314-867-8818
Fax Number	:	314-867-8817

Provider Business Practice Location Address
First Line	:	8522 OLIVE BLVD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63132-2818
Country	:	US
Telephone Number	:	314-867-8818
Fax Number	:	314-867-8817

Authorized Official
Title or Position	:	MANAGER
Name	:	SHIRLEY NADINE HEMPHILL
Credential	:
Telephone Number	:	314-867-8818

Provider Enumeration Date	:	05/30/2019
Last Update Date	:	05/30/2019

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