Organization
PAVILION HEALTH COMPANY, LLC
Active
Other names
Pavilion Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
NAGARAJ V KUNDA (DIRECTOR/OWNER)
(314) 377-9110
Entity
Organization
Contact information
Practice address
11520 SAINT CHARLES ROCK RD STE 105A, BRIDGETON, MO 63044-2732
(314) 312-5588
Mailing address
11520 SAINT CHARLES ROCK RD STE 105A, BRIDGETON, MO 63044-2732
(314) 312-5588
(314) 377-9110
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
620112387
—
MO
Enumeration date
12/07/2020
Last updated
01/22/2026
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