Provider Demographics
NPI:1508463944
Name:TRUCARE PROVIDER SERVICES LLC
Entity Type:Organization
Organization Name:TRUCARE PROVIDER SERVICES LLC
Other - Org Name:TRUCARE PROVIDER SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEMUEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-201-5708
Mailing Address - Street 1:3600 PARK 42 DR STE 3670
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45241-4049
Mailing Address - Country:US
Mailing Address - Phone:513-201-5708
Mailing Address - Fax:513-510-4911
Practice Address - Street 1:3600 PARK 42 DR STE 3670
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45241-4049
Practice Address - Country:US
Practice Address - Phone:513-201-5708
Practice Address - Fax:513-510-4911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-08
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Multi-Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No333300000XSuppliersEmergency Response System Companies
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0314089Medicaid