MEDICARE: SPECIALTY THERAPEUTIC CARE LP

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	251F00000X	Home Infusion Agency
2	332B00000X	Durable Medical Equipment & Medical Supplies
3	3336S0011X	Specialty Pharmacy	TX
4	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	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
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	2097210	OTHER	PK
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
12	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
13	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
14	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
15	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
16	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
17	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
18	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
19	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962406850
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPECIALTY THERAPEUTIC CARE LP

Provider Business Mailing Address
First Line	:	PO BOX 956780
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63195-6780
Country	:	US
Telephone Number	:	855-422-2742
Fax Number	:	866-834-8523

Provider Business Practice Location Address
First Line	:	1311 W SAM HOUSTON PKWY N STE 150
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77043
Country	:	US
Telephone Number	:	866-506-2626
Fax Number	:	866-834-8523

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JESSICA DAWN CICCOLELLA-KAHL
Credential	:
Telephone Number	:	800-511-5144

Provider Enumeration Date	:	06/08/2005
Last Update Date	:	02/09/2024

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MEDICARE: SPECIALTY THERAPEUTIC CARE LP

Scope of Practice

Other Identifiers

General Provider Information

Similar Medicare Providers

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