Provider Demographics
NPI:1336610864
Name:PLATINUM MEDICAL CARE LLC
Entity Type:Organization
Organization Name:PLATINUM MEDICAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PETE
Authorized Official - Middle Name:
Authorized Official - Last Name:BUCKLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-988-6832
Mailing Address - Street 1:25 ARTIST DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47448-8101
Mailing Address - Country:US
Mailing Address - Phone:812-988-6832
Mailing Address - Fax:
Practice Address - Street 1:25 ARTIST DR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:IN
Practice Address - Zip Code:47448-8101
Practice Address - Country:US
Practice Address - Phone:812-988-6832
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-10
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health