Provider Demographics
NPI:1497827570
Name:SOUTH CENTRAL HOME HEALTH CARE INC
Entity Type:Organization
Organization Name:SOUTH CENTRAL HOME HEALTH CARE INC
Other - Org Name:SOUTH CENTRAL HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BIRCHEM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-446-8953
Mailing Address - Street 1:303 SW LORRAINE ST
Mailing Address - Street 2:
Mailing Address - City:LEON
Mailing Address - State:IA
Mailing Address - Zip Code:50144-1178
Mailing Address - Country:US
Mailing Address - Phone:641-446-8953
Mailing Address - Fax:641-446-4013
Practice Address - Street 1:303 SW LORRAINE ST
Practice Address - Street 2:
Practice Address - City:LEON
Practice Address - State:IA
Practice Address - Zip Code:50144-1178
Practice Address - Country:US
Practice Address - Phone:641-446-8953
Practice Address - Fax:641-446-4013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0672840Medicaid
IA16-7284Medicare ID - Type UnspecifiedMEDICARE PROVIDER #