Provider Demographics
NPI:1710935903
Name:MEDCARE HOME MEDICAL LLC
Entity Type:Organization
Organization Name:MEDCARE HOME MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:STRINGFELLOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-459-5500
Mailing Address - Street 1:2295 HILLTOP DR
Mailing Address - Street 2:STE 3
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96002-0515
Mailing Address - Country:US
Mailing Address - Phone:530-246-4363
Mailing Address - Fax:530-246-4010
Practice Address - Street 1:2295 HILLTOP DR
Practice Address - Street 2:STE 3
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-0515
Practice Address - Country:US
Practice Address - Phone:530-246-4363
Practice Address - Fax:530-246-4010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-04
Last Update Date:2010-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45310332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5622000002Medicare NSC