Healthcare Provider Details

I. General information

NPI: 1174684203
Provider Name (Legal Business Name): TRUE CARE HOME HEALTH EQUIPMENT SALES AND SERVICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 12/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 W. MAPLE
PILOT KNOB MO
63663
US

IV. Provider business mailing address

303 W. MAPLE PO BOX 507
PILOT KNOB MO
63663
US

V. Phone/Fax

Practice location:
  • Phone: 573-546-0241
  • Fax: 573-546-0261
Mailing address:
  • Phone: 573-546-0241
  • Fax: 573-546-0261

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License NumberNA
License Number StateMO

VIII. Authorized Official

Name: MR. SHAWN SMITH
Title or Position: OWNER
Credential:
Phone: 573-546-0241