Provider Demographics
NPI:1871660316
Name:PATIENT ADVOCATE HOME CARE, LLC
Entity Type:Organization
Organization Name:PATIENT ADVOCATE HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:RAYMOND
Authorized Official - Last Name:BUIKEMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-663-1430
Mailing Address - Street 1:PO BOX 11440
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46411-1440
Mailing Address - Country:US
Mailing Address - Phone:219-663-1430
Mailing Address - Fax:219-663-1431
Practice Address - Street 1:1290 ARROWHEAD CT
Practice Address - Street 2:SUITE B
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-8222
Practice Address - Country:US
Practice Address - Phone:219-663-1430
Practice Address - Fax:219-663-1431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2009-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN69000125A332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200244240AMedicaid
IN200244240AMedicaid