Provider Demographics
NPI:1477683126
Name:HOME CARE NURSING, INC.
Entity Type:Organization
Organization Name:HOME CARE NURSING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:BERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-747-1678
Mailing Address - Street 1:3370 DELASSUS RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63640-7001
Mailing Address - Country:US
Mailing Address - Phone:573-747-1678
Mailing Address - Fax:
Practice Address - Street 1:3370 DELASSUS RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:MO
Practice Address - Zip Code:63640-7001
Practice Address - Country:US
Practice Address - Phone:573-747-1678
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0005434251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health