Provider Demographics
NPI:1639588684
Name:AIR 24 HOMECARE, LLC
Entity Type:Organization
Organization Name:AIR 24 HOMECARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:BERNARD
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:DOWLING
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:618-235-5945
Mailing Address - Street 1:1716 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63104-4049
Mailing Address - Country:US
Mailing Address - Phone:314-240-5005
Mailing Address - Fax:314-240-5006
Practice Address - Street 1:1716 S BROADWAY
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63104-4049
Practice Address - Country:US
Practice Address - Phone:314-240-5005
Practice Address - Fax:314-240-5006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-04
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health