Provider Demographics
NPI:1811221724
Name:MIDWEST CARE PARIS LLC
Entity Type:Organization
Organization Name:MIDWEST CARE PARIS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF ACCOUNTING AND FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:KANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-747-3373
Mailing Address - Street 1:78 CENTENNIAL LOOP
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-7900
Mailing Address - Country:US
Mailing Address - Phone:541-747-3373
Mailing Address - Fax:
Practice Address - Street 1:146 BROOKSTONE EST
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:IL
Practice Address - Zip Code:61944-9603
Practice Address - Country:US
Practice Address - Phone:217-463-5871
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-24
Last Update Date:2009-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service