Provider Demographics
NPI:1558798645
Name:COUNTYCARE,LLC
Entity Type:Organization
Organization Name:COUNTYCARE,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:UMAR
Authorized Official - Middle Name:Y
Authorized Official - Last Name:JUNGUDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-378-8620
Mailing Address - Street 1:2400 VINING DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-4779
Mailing Address - Country:US
Mailing Address - Phone:614-378-8620
Mailing Address - Fax:
Practice Address - Street 1:2400 VINING DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-4779
Practice Address - Country:US
Practice Address - Phone:614-378-8620
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-03
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health