Healthcare Provider Details

I. General information

NPI: 1750335220
Provider Name (Legal Business Name): MEDCARE PROFESSIONALS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 08/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

730 E TIFFIN ST SUITE 2
WILLARD OH
44890-9429
US

IV. Provider business mailing address

730 E TIFFIN ST SUITE 2
WILLARD OH
44890-9429
US

V. Phone/Fax

Practice location:
  • Phone: 419-933-4633
  • Fax: 419-964-0507
Mailing address:
  • Phone: 419-933-4633
  • Fax: 419-964-0507

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MELISSA ANN STUMBO
Title or Position: OWNER
Credential: LPN
Phone: 419-933-4633