Provider Demographics
NPI:1295851335
Name:SIR CARE, LLC
Entity Type:Organization
Organization Name:SIR CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:J
Authorized Official - Last Name:STOLLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:574-291-2273
Mailing Address - Street 1:18444 MADISON RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46614-9799
Mailing Address - Country:US
Mailing Address - Phone:574-291-2273
Mailing Address - Fax:574-291-6774
Practice Address - Street 1:18444 MADISON RD
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46614-9799
Practice Address - Country:US
Practice Address - Phone:574-291-2273
Practice Address - Fax:574-291-6774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01021580A207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Single Specialty