MEDICARE: TRILOGY HEALTHCARE

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	7583HH	MO
2	251F00000X	Home Infusion Agency
3	332B00000X	Durable Medical Equipment & Medical Supplies	5312350001
4	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)	5312350001
5	332BX2000X	Oxygen Equipment & Supplies (DME)	5312350001
6	335E00000X	Prosthetic/Orthotic Supplier
7	3336H0001X	Home Infusion Therapy Pharmacy	2004020806	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7583HH	OTHER	MO	STATE LICENSE HOME HEALTH

General Provider Information

NPI Number	:	1598991739
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRILOGY HEALTHCARE

Provider Business Mailing Address
First Line	:	1876 CRAIGSHIRE RD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63146-4006
Country	:	US
Telephone Number	:	314-542-0022
Fax Number	:	314-317-9357

Provider Business Practice Location Address
First Line	:	1876 CRAIGSHIRE RD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63146-4006
Country	:	US
Telephone Number	:	314-542-0022
Fax Number	:	314-317-9357

Authorized Official
Title or Position	:	GENERAL MANAGER
Name	:	RUTH BROWN
Credential	:
Telephone Number	:	314-542-0022

Provider Enumeration Date	:	06/02/2009
Last Update Date	:	06/02/2009

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Directions to “TRILOGY HEALTHCARE ” Practice Location

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