Provider Demographics
NPI:1558383521
Name:A&M HOME HEALTH CARE LLC
Entity Type:Organization
Organization Name:A&M HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATION MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHONEY
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:314-458-9041
Mailing Address - Street 1:11148 DE MALLE DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63146-5304
Mailing Address - Country:US
Mailing Address - Phone:314-458-9041
Mailing Address - Fax:314-989-1452
Practice Address - Street 1:11148 DE MALLE DR
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63146-5304
Practice Address - Country:US
Practice Address - Phone:314-458-9041
Practice Address - Fax:314-989-1452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO85Medicaid