Foundation Care LLC – Pharmacy, NPI 1205831963

Foundation Care LLC is a healthcare provider. based in Chesterfield, Missouri. specializing in Pharmacy. The organization holds a License No. 2004013283 (MO). The NPI Number for Foundation Care LLC is 1205831963

Main info

Organization
Name
Foundation Care LLC
NPI
1205831963
Phone
(877) 291-1122
Address
111 CHESTERFIELD INDUSTRIAL BLVD STE 115
Authorized Official
JESSICA DAWN CICCOLELLA-KAHL PRESIDENT, DIRECTOR
Enumeration Date
17 June 2005
Last Update Date
22 May 2024
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience74
Completeness80
Years active:20State licenses:1Digital endpointsUpdated within 12 months

Provider Addresses for Foundation Care LLC

  • 111 CHESTERFIELD INDUSTRIAL BLVD STE 115

    CHESTERFIELD, MO 630051219

    Phone: (877) 291-1122

    Fax: (877) 291-1155

    Type: Location

  • 4010, Wedgeway Court, Earth City, Saint Louis County, Missouri, 63045, United States

    EARTH CITY, MO 63045

    Phone: (877) 291-1122

    Fax: (877) 291-1155

    Type: Location

  • PO BOX 955362

    SAINT LOUIS, MO 631955362

    Phone: (855) 422-2742

    Fax: (866) 834-8523

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-09-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2023-08-31 (1014 days ago).

Enrollment records

3

Earliest due date

2023-08-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20090922000276OMass Immunization (Roster Biller Only)MO2023-08-31
O20091104000315OPharmacyMO2023-08-31
O20100930029414OPharmacyMO2024-10-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 63005)

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Reviews

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Frequently asked questions

How do I look up Foundation Care LLC by NPI?
Use NPI 1205831963 when you need to reference Foundation Care LLC in forms, claims, or directories.
Does this profile mean Foundation Care LLC is currently active?
Yes — Foundation Care LLC appears active in the national provider directory.
Can you summarize Foundation Care LLC's specialty in plain language?
Clinically, the directory lists Foundation Care LLC with Pharmacy. Clinical services aligned with this taxonomy classification.
Where is Foundation Care LLC's primary listing?
We display Chesterfield, Missouri because that is what the record indicates for Foundation Care LLC.
What if Chesterfield, Missouri seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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