Basic Information
| Provider Information | |||||||||
| NPI: | 1841355047 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | MISSOURI HOME CARE | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | AUXI HEALTH COMPANY | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1026 KINGSHIGHWAY ST | ||||||||
| Address2: | |||||||||
| City: | ROLLA | ||||||||
| State: | MO | ||||||||
| PostalCode: | 654012921 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5733643610 | ||||||||
| FaxNumber: | 5734262034 | ||||||||
| Practice Location | |||||||||
| Address1: | 1026 KINGSHIGHWAY ST | ||||||||
| Address2: | |||||||||
| City: | ROLLA | ||||||||
| State: | MO | ||||||||
| PostalCode: | 654012921 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5733643610 | ||||||||
| FaxNumber: | 5734262034 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/27/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | KRAMME | ||||||||
| AuthorizedOfficialFirstName: | MARY KAYE | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | REGIONAL VICE PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5733643610 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 3747P1801X | 6527 | MO | Y | 193400000X SINGLE SPECIALTY GROUP | Nursing Service Related Providers | Technician | Personal Care Attendant |
No ID Information.