MEDICARE: HARMONY IN-HOME HEALTHCARE SERVICE INC.

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		MO

General Provider Information

NPI Number	:	1770990541
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARMONY IN-HOME HEALTHCARE SERVICE INC.

Provider Business Mailing Address
First Line	:	5822 S GRAND BLVD FL 1
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63111-2305
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5822 S GRAND BLVD FL 1
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63111-2305
Country	:	US
Telephone Number	:	314-752-4444
Fax Number	:	314-752-4451

Authorized Official
Title or Position	:	DIRECTOR
Name	:	JIMMIE LEE WATKINS
Credential	:
Telephone Number	:	314-752-4444

Provider Enumeration Date	:	07/14/2014
Last Update Date	:	07/14/2014

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