MEDICARE: RELIABLE HOME HEALTH SERVICE 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	376J00000X	Homemaker
2	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1881246056
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RELIABLE HOME HEALTH SERVICE LLC

Provider Business Mailing Address
First Line	:	2126 WOODSON RD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63114-5616
Country	:	US
Telephone Number	:	314-427-2650
Fax Number	:	314-426-1474

Provider Business Practice Location Address
First Line	:	2126 WOODSON RD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63114-5616
Country	:	US
Telephone Number	:	314-427-2650
Fax Number	:	314-426-1474

Authorized Official
Title or Position	:	DIRECTOR/OWNER
Name	:	MRS. SHARON SMITH
Credential	:
Telephone Number	:	314-427-2650

Provider Enumeration Date	:	07/09/2019
Last Update Date	:	07/09/2019

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