Organization
FOUNDATION CARE LLC
Active
Other names
Foundation Care LLC
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA DAWN CICCOLELLA-KAHL (PRESIDENT, DIRECTOR)
(800) 511-5144
Entity
Organization
Contact information
Practice address
111 CHESTERFIELD INDUSTRIAL BLVD STE 115, CHESTERFIELD, MO 63005-1219
(877) 291-1122
(877) 291-1155
Mailing address
PO BOX 955362, SAINT LOUIS, MO 63195-5362
(855) 422-2742
(866) 834-8523
Taxonomy
Speciality
Code
Description
License number
State
251F00000X
Home Infusion Agency
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
2004013283
MO
333600000X
Pharmacy
Primary
2004013283
MO
3336H0001X
Home Infusion Therapy Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2172192
PK
—
05
—
606143006
—
MO
Enumeration date
06/17/2005
Last updated
05/22/2024
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