Provider Demographics
NPI:1689847840
Name:INDEPENDENT HOMECARE
Entity Type:Organization
Organization Name:INDEPENDENT HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:PATRICE
Authorized Official - Last Name:DINWIDDIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-324-1260
Mailing Address - Street 1:10608 CROWLEY DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63136-2427
Mailing Address - Country:US
Mailing Address - Phone:314-521-7777
Mailing Address - Fax:314-521-7777
Practice Address - Street 1:10608 CROWLEY DR
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63136-2427
Practice Address - Country:US
Practice Address - Phone:314-521-7777
Practice Address - Fax:314-521-7777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-09
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health