MEDICARE: CINDYSHOMEHEALTHCARELLC

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881135952
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CINDYSHOMEHEALTHCARELLC

Provider Business Mailing Address
First Line	:	9424 GUTHRIE AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63134-3914
Country	:	US
Telephone Number	:	314-427-9996
Fax Number	:	314-427-9998

Provider Business Practice Location Address
First Line	:	9424 GUTHRIE AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63134-3914
Country	:	US
Telephone Number	:	314-427-9996
Fax Number	:	314-427-9998

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. CYNTHIA GLYNETTE LASTER
Credential	:	LPN
Telephone Number	:	314-427-9996

Provider Enumeration Date	:	03/09/2017
Last Update Date	:	03/09/2017

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Directions to “CINDYSHOMEHEALTHCARELLC ” Practice Location

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