Basic Information
| Provider Information | |||||||||
| NPI: | 1629721576 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MINISTRY HOME CARE SERVICES, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10 CADILLAC DR STE 400 | ||||||||
| Address2: | |||||||||
| City: | BRENTWOOD | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370271001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4178414834 | ||||||||
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| Practice Location | |||||||||
| Address1: | 10050 S 27TH ST STE 100 | ||||||||
| Address2: | |||||||||
| City: | OAK CREEK | ||||||||
| State: | WI | ||||||||
| PostalCode: | 531545520 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4145630510 | ||||||||
| FaxNumber: | 4145630600 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/01/2022 | ||||||||
| LastUpdateDate: | 02/01/2022 | ||||||||
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| AuthorizedOfficialLastName: | ADKINS | ||||||||
| AuthorizedOfficialFirstName: | RUSSELL | ||||||||
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| AuthorizedOfficialTitleorPosition: | SVP CHIEF LEGAL OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 6153095668 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 01/21/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251F00000X | N | Agencies | Home Infusion | 332B00000X | N | Suppliers | Durable Medical Equipment & Medical Supplies | 333600000X | Y | Suppliers | Pharmacy |
No ID Information.