MEDICARE: MISS TAMIKA T GRIFFIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	372500000X	Chore Provider
2	372600000X	Adult Companion
3	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1740763358
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS TAMIKA T GRIFFIN

Provider Business Mailing Address
First Line	:	100 CAMERON RD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63137-4209
Country	:	US
Telephone Number	:	314-479-1602
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 CAMERON RD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63137-4209
Country	:	US
Telephone Number	:	314-702-0108
Fax Number	:

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

Provider Enumeration Date	:	09/10/2018
Last Update Date	:	09/10/2018

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Directions to “ MISS TAMIKA T GRIFFIN ” Practice Location

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