Healthcare Provider Details

I. General information

NPI: 1841302734
Provider Name (Legal Business Name): PLOTT CARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 E 5TH ST SUITE A
ONTARIO CA
91764-2432
US

IV. Provider business mailing address

800 E 5TH ST SUITE A
ONTARIO CA
91764-2432
US

V. Phone/Fax

Practice location:
  • Phone: 909-635-0414
  • Fax: 909-984-7749
Mailing address:
  • Phone: 909-635-0414
  • Fax: 909-984-7749

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MRS. ELIZABETH R. PLOTT
Title or Position: OWNER
Credential:
Phone: 909-635-0414