MEDICARE: OZIK HOME CARE 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	253Z00000X	In Home Supportive Care Agency	795-1HH	MO
2	251E00000X	Home Health Agency	774	MO

General Provider Information

NPI Number	:	1972631125
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OZIK HOME CARE INC

Provider Business Mailing Address
First Line	:	3470 HAMPTON AVE
Second Line	:	STE 103
City	:	SAINT LOUIS
State	:	MO
Zip	:	63139-1946
Country	:	US
Telephone Number	:	314-454-1219
Fax Number	:	314-454-1382

Provider Business Practice Location Address
First Line	:	3470 HAMPTON AVE
Second Line	:	STE 103
City	:	SAINT LOUIS
State	:	MO
Zip	:	63139-1946
Country	:	US
Telephone Number	:	314-454-1219
Fax Number	:	314-454-1382

Authorized Official
Title or Position	:	MANAGER
Name	:	DR. ISAAC ONYEMA
Credential	:
Telephone Number	:	314-454-1219

Provider Enumeration Date	:	03/01/2007
Last Update Date	:	02/27/2015

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