Provider Demographics
NPI:1336445667
Name:PATIENT CARE LLC
Entity Type:Organization
Organization Name:PATIENT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CNA
Authorized Official - Prefix:
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:FRAIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-312-8094
Mailing Address - Street 1:4879 N 39 STREET
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53209
Mailing Address - Country:US
Mailing Address - Phone:414-312-8094
Mailing Address - Fax:414-226-6578
Practice Address - Street 1:4879 N 39 STREET
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53209
Practice Address - Country:US
Practice Address - Phone:414-312-8094
Practice Address - Fax:414-226-6578
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PATIENT CARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-02-03
Last Update Date:2011-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty