Healthcare Provider Details

I. General information

NPI: 1720597875
Provider Name (Legal Business Name): ROOTS & COMPANY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2017
Last Update Date: 06/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3485 WINDSOR AVE
DUBUQUE IA
52001-1329
US

IV. Provider business mailing address

5678 LONG MEADOW CT
JOHNSTON IA
50131-2880
US

V. Phone/Fax

Practice location:
  • Phone: 563-587-0000
  • Fax: 844-331-5887
Mailing address:
  • Phone: 563-587-0000
  • Fax: 844-331-5887

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State

VIII. Authorized Official

Name: MIKA WELLING
Title or Position: VICE PRESIDENT/SECRETARY
Credential:
Phone: 563-587-0000