Provider Demographics
NPI:1952997181
Name:MMC HOME HEALTHCARE INC
Entity Type:Organization
Organization Name:MMC HOME HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-414-0566
Mailing Address - Street 1:37245 80TH AVE
Mailing Address - Street 2:
Mailing Address - City:PILLAGER
Mailing Address - State:MN
Mailing Address - Zip Code:56473-8009
Mailing Address - Country:US
Mailing Address - Phone:218-414-0566
Mailing Address - Fax:218-743-3072
Practice Address - Street 1:37245 80TH AVE
Practice Address - Street 2:
Practice Address - City:PILLAGER
Practice Address - State:MN
Practice Address - Zip Code:56473-8009
Practice Address - Country:US
Practice Address - Phone:218-414-0566
Practice Address - Fax:218-743-3072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-11
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNA958693200OtherUMPI