Provider Demographics
NPI:1831306687
Name:SUPPORTIVE CARE COORDINATORS
Entity Type:Organization
Organization Name:SUPPORTIVE CARE COORDINATORS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:EIRE
Authorized Official - Last Name:MCAULEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:1641-330-2541
Mailing Address - Street 1:1260 PLYMOUTH RD APT 1
Mailing Address - Street 2:
Mailing Address - City:MASON CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50401-1475
Mailing Address - Country:US
Mailing Address - Phone:641-330-2541
Mailing Address - Fax:
Practice Address - Street 1:1260 PLYMOUTH RD APT 1
Practice Address - Street 2:
Practice Address - City:MASON CITY
Practice Address - State:IA
Practice Address - Zip Code:50401-1475
Practice Address - Country:US
Practice Address - Phone:641-330-2541
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health