Provider Demographics
NPI:1831216068
Name:P.M.C.C. HOMEMAKER CHORE SVC.
Entity type:Organization
Organization Name:P.M.C.C. HOMEMAKER CHORE SVC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ASSIST. ADMIN.
Authorized Official - Prefix:MR
Authorized Official - First Name:SHADRACH
Authorized Official - Middle Name:ANTIONE
Authorized Official - Last Name:MCGILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-732-7506
Mailing Address - Street 1:437 THOMAS AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63135-2658
Mailing Address - Country:US
Mailing Address - Phone:314-522-0002
Mailing Address - Fax:314-522-0009
Practice Address - Street 1:437 THOMAS AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63135-2658
Practice Address - Country:US
Practice Address - Phone:314-522-0002
Practice Address - Fax:314-522-0009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO0001992OtherTITLE 20