1477926848 NPI number — MEADOWLARK HOME CARE LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477926848 NPI number — MEADOWLARK HOME CARE LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MEADOWLARK 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:
1477926848
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/09/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
800 KENSINGTON AVE STE LL3
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MISSOULA
Provider Business Mailing Address State Name:
MT
Provider Business Mailing Address Postal Code:
59801-5670
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
406-239-8777
Provider Business Mailing Address Fax Number:
406-926-1501

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
800 KENSINGTON
Provider Second Line Business Practice Location Address:
SUITE LL3
Provider Business Practice Location Address City Name:
MISSOULA
Provider Business Practice Location Address State Name:
MT
Provider Business Practice Location Address Postal Code:
59801
Provider Business Practice Location Address Country Code:
UM
Provider Business Practice Location Address Telephone Number:
406-239-8777
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/07/2015

Additional Information

Authorized Official

Authorized Official Last Name:
REDMAN
Authorized Official First Name:
NATALIE
Authorized Official Middle Name:
R
Authorized Official Title or Position:
CO- OWNER
Authorized Official Telephone Number:
406-926-3447

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0391709 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com