Provider Demographics
NPI:1952722464
Name:CAREMATE HOME HEALTH CARE, INC.
Entity Type:Organization
Organization Name:CAREMATE HOME HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TIM
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:KORAN
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:651-659-0208
Mailing Address - Street 1:2236 MARSHALL AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-5799
Mailing Address - Country:US
Mailing Address - Phone:651-659-0208
Mailing Address - Fax:651-659-0161
Practice Address - Street 1:2236 MARSHALL AVE
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-5799
Practice Address - Country:US
Practice Address - Phone:651-659-0208
Practice Address - Fax:651-659-0161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-31
Last Update Date:2013-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1588734966251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN868K1CAOtherBCBS