Provider Demographics
NPI:1891260303
Name:WEE CARE PEDIATRIC HOME MEDICAL, LLC
Entity Type:Organization
Organization Name:WEE CARE PEDIATRIC HOME MEDICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:DONEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-230-7484
Mailing Address - Street 1:4155 RED TALON CIR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-4802
Mailing Address - Country:US
Mailing Address - Phone:907-230-7484
Mailing Address - Fax:
Practice Address - Street 1:4155 RED TALON CIR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-4802
Practice Address - Country:US
Practice Address - Phone:907-230-7484
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-11
Last Update Date:2018-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK=========OtherIRS CP575