MEDICARE: 4D.R 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	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1750215117
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	4D.R LLC

Provider Business Mailing Address
First Line	:	2965 DEVONSHIRE DR
Second Line	:
City	:	FLORISSANT
State	:	MO
Zip	:	63033-1319
Country	:	US
Telephone Number	:	314-369-7239
Fax Number	:

Provider Business Practice Location Address
First Line	:	2965 DEVONSHIRE DR
Second Line	:
City	:	FLORISSANT
State	:	MO
Zip	:	63033-1319
Country	:	US
Telephone Number	:	314-369-7239
Fax Number	:

Authorized Official
Title or Position	:	OWNER/OPERATOR
Name	:	DELORES ONEAL
Credential	:
Telephone Number	:	314-369-7239

Provider Enumeration Date	:	06/10/2026
Last Update Date	:	06/10/2026

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