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Organization

SPECIALTY THERAPEUTIC CARE LP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JESSICA DAWN CICCOLELLA-KAHL (PRESIDENT)
(800) 511-5144
Entity
Organization

Contact information

Practice address
1311 W SAM HOUSTON PKWY N STE 150, HOUSTON, TX 77043
(866) 506-2626
(866) 834-8523
Mailing address
PO BOX 956780, SAINT LOUIS, MO 63195-6780
(855) 422-2742
(866) 834-8523

Taxonomy

Speciality
Code
Description
License number
State
251F00000X
Home Infusion Agency
332B00000X
Durable Medical Equipment & Medical Supplies
3336C0003X
Community/Retail Pharmacy
Primary
3336S0011X
Specialty Pharmacy
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003136712A
GA
05
0160873
OH
05
10100264788-00
NV
05
131430006
ME
05
148018
TX
05
1578774
AK
05
192697407
AR
05
1962406850
ID
05
1962406850
ME
05
1962406850
TN
05
200096950A
OK
01
2097210
PK
05
3094450
NH
05
6029680
WA
05
7100232400
KY
05
73169880001
IL
05
7T4102
SC
05
WY0122
WY
Enumeration date
06/08/2005
Last updated
02/09/2024
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