# FOUNDATION CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Foundation Care LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205831963
- **Authorized official:** JESSICA DAWN CICCOLELLA-KAHL (PRESIDENT, DIRECTOR)
- **Authorized official phone:** (800) 511-5144

## Contact information

- **Practice address:** 111 CHESTERFIELD INDUSTRIAL BLVD STE 115, CHESTERFIELD, MO 63005-1219
- **Practice address phone:** (877) 291-1122
- **Practice address fax:** (877) 291-1155
- **Mailing address:** PO BOX 955362, SAINT LOUIS, MO 63195-5362
- **Mailing address phone:** (855) 422-2742
- **Mailing address fax:** (866) 834-8523

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251F00000X | Home Infusion Agency | — | — | — |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 2004013283 | MO | — |
| 333600000X | Pharmacy | 2004013283 | MO | Yes |
| 3336H0001X | Home Infusion Therapy Pharmacy | — | — | — |

## Other

- **Enumeration date:** 06/17/2005
- **Last updated:** 05/22/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2172192 | PK | — |
| 05 | — | 606143006 | — | MO |