1710155775 NPI number — WORLDWIDE SENIOR HOME CARE LLC

Table of content: (NPI 1710155775)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710155775 NPI number — WORLDWIDE SENIOR HOME CARE LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WORLDWIDE SENIOR HOME CARE LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1710155775
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/13/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 400
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WILLOW SPRINGS
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
65793-1517
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
417-469-5548
Provider Business Mailing Address Fax Number:
417-469-0473

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
821 E MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WILLOW SPRINGS
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
65793-1517
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
417-469-5548
Provider Business Practice Location Address Fax Number:
417-469-0473
Provider Enumeration Date:
02/13/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
VENN
Authorized Official First Name:
CURTIS
Authorized Official Middle Name:
EDWARD
Authorized Official Title or Position:
PARTNER
Authorized Official Telephone Number:
417-469-5548

Provider Taxonomy Codes

  • Taxonomy code: 372500000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 372600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 374U00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 376J00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)