MEDICARE: VENETTA BONDS

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1538926050
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VENETTA BONDS

Provider Business Mailing Address
First Line	:	4208 LINTON AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63107-1614
Country	:	US
Telephone Number	:	314-450-0493
Fax Number	:

Provider Business Practice Location Address
First Line	:	4208 LINTON AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63107-1614
Country	:	US
Telephone Number	:	314-450-0493
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/01/2024
Last Update Date	:	03/01/2024

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Directions to “ VENETTA BONDS ” Practice Location

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