Provider Demographics
NPI:1144580416
Name:MEDCARE LLC
Entity Type:Organization
Organization Name:MEDCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MATHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHN
Authorized Official - Suffix:
Authorized Official - Credentials:RT
Authorized Official - Phone:469-877-9417
Mailing Address - Street 1:1350 N BUCKNER BLVD
Mailing Address - Street 2:SUITE 222
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75218-3500
Mailing Address - Country:US
Mailing Address - Phone:469-877-9417
Mailing Address - Fax:972-303-1620
Practice Address - Street 1:1350 N BUCKNER BLVD
Practice Address - Street 2:SUITE 222
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75218-3500
Practice Address - Country:US
Practice Address - Phone:469-877-9417
Practice Address - Fax:972-303-1620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-21
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health