MEDICARE: ABC HEALTHCARE PROGRAMS

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	163W00000X	Registered Nurse
2	164W00000X	Licensed Practical Nurse
3	3747P1801X	Personal Care Attendant
4	374U00000X	Home Health Aide
5	376J00000X	Homemaker
6	376K00000X	Nurse's Aide
7	372500000X	Chore Provider

General Provider Information

NPI Number	:	1972906535
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABC HEALTHCARE PROGRAMS

Provider Business Mailing Address
First Line	:	1173 N PRICE RD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63132-2301
Country	:	US
Telephone Number	:	314-569-1899
Fax Number	:	314-569-9026

Provider Business Practice Location Address
First Line	:	1173 N PRICE RD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63132-2301
Country	:	US
Telephone Number	:	314-569-1899
Fax Number	:	314-569-9026

Authorized Official
Title or Position	:	OWNER
Name	:	SAMUELA KOYFMAN
Credential	:
Telephone Number	:	314-591-2214

Provider Enumeration Date	:	09/26/2014
Last Update Date	:	09/26/2014

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Directions to “ABC HEALTHCARE PROGRAMS ” Practice Location

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