Provider Demographics
NPI:1922674613
Name:MEDICAB HOME CARE LLC
Entity Type:Organization
Organization Name:MEDICAB HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VOO
Authorized Official - Prefix:MR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:GITAU
Authorized Official - Last Name:NDUNG'U
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-980-3900
Mailing Address - Street 1:13240 N CLEVELAND AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:NORTH FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33903-4855
Mailing Address - Country:US
Mailing Address - Phone:239-980-3900
Mailing Address - Fax:877-745-8863
Practice Address - Street 1:13240 N CLEVELAND AVE STE 4
Practice Address - Street 2:
Practice Address - City:NORTH FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33903-4855
Practice Address - Country:US
Practice Address - Phone:239-980-3900
Practice Address - Fax:877-745-8863
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-02
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health