Provider Demographics
NPI:1518980614
Name:GALESBURG HOME CARE CORPORATION
Entity Type:Organization
Organization Name:GALESBURG HOME CARE CORPORATION
Other - Org Name:MIDWEST REGIONAL HOME CARE/OPTION CARE MIDWEST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:TEDDIE
Authorized Official - Middle Name:
Authorized Official - Last Name:RINEHART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-343-9031
Mailing Address - Street 1:427 E FREMONT ST
Mailing Address - Street 2:
Mailing Address - City:GALESBURG
Mailing Address - State:IL
Mailing Address - Zip Code:61401-0505
Mailing Address - Country:US
Mailing Address - Phone:309-343-9031
Mailing Address - Fax:309-343-8057
Practice Address - Street 1:427 E FREMONT ST
Practice Address - Street 2:
Practice Address - City:GALESBURG
Practice Address - State:IL
Practice Address - Zip Code:61401-0505
Practice Address - Country:US
Practice Address - Phone:309-343-9031
Practice Address - Fax:309-343-8057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
IL251F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered251F00000XAgenciesHome Infusion
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0749119Medicaid
IL=========001Medicaid
IL5743150002Medicare NSC