Provider Demographics
NPI:1114011277
Name:MINISTRY HOME CARE SERVICES, LLC
Entity Type:Organization
Organization Name:MINISTRY HOME CARE SERVICES, LLC
Other - Org Name:MINISTRY HOME CARE PLUS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR DIRECTOR OF FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:KAMINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-387-7294
Mailing Address - Street 1:611 ST. JOSEPH AVENUE
Mailing Address - Street 2:4 SOUTH
Mailing Address - City:MARSHFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:54449-1832
Mailing Address - Country:US
Mailing Address - Phone:715-389-3802
Mailing Address - Fax:715-387-9950
Practice Address - Street 1:1571 HIGHWAY 51 NORTH
Practice Address - Street 2:SUITE B
Practice Address - City:ARBOR VITAE
Practice Address - State:WI
Practice Address - Zip Code:54568
Practice Address - Country:US
Practice Address - Phone:715-356-2700
Practice Address - Fax:715-356-2218
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MINISTRY HOME CARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-03
Last Update Date:2009-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI004-0000579853-01332B00000X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI456-0000579853-02OtherSELLER'S PERMIT
WI41718400Medicaid
WI456-0000579853-02OtherSELLER'S PERMIT