Provider Demographics
NPI:1124485842
Name:PARAMOUNT HEALTH CARE LLC
Entity type:Organization
Organization Name:PARAMOUNT HEALTH CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOVAN
Authorized Official - Middle Name:DURRELL
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-629-5355
Mailing Address - Street 1:1409 WASHINGTON AVE
Mailing Address - Street 2:SUITE 221
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63103-1936
Mailing Address - Country:US
Mailing Address - Phone:314-629-5355
Mailing Address - Fax:314-344-5003
Practice Address - Street 1:1409 WASHINGTON AVE
Practice Address - Street 2:SUITE 221
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63103-1936
Practice Address - Country:US
Practice Address - Phone:314-629-5355
Practice Address - Fax:314-344-5003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-26
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health