Healthcare Provider Details
I. General information
NPI: 1356637615
Provider Name (Legal Business Name): COMPLETE HOME CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/24/2011
Last Update Date: 03/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6709 S MINNESOTA AVENUE SUITE 105
SIOUX FALLS SD
57108-2593
US
IV. Provider business mailing address
6709 S MINNESOTA AVENUE SUITE 105
SIOUX FALLS SD
57108-2593
US
V. Phone/Fax
- Phone: 605-338-3938
- Fax: 605-338-1693
- Phone: 605-338-9383
- Fax: 605-338-1693
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | 100-1964 |
| License Number State | SD |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BX2000X |
| Taxonomy | Oxygen Equipment & Supplies (DME) |
| License Number | 100-1964 |
| License Number State | SD |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | 100-1964 |
| License Number State | SD |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336H0001X |
| Taxonomy | Home Infusion Therapy Pharmacy |
| License Number | 100-1964 |
| License Number State | SD |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336L0003X |
| Taxonomy | Long Term Care Pharmacy |
| License Number | 100-1964 |
| License Number State | SD |
VIII. Authorized Official
Name: DR.
THOMAS
K
CHIU
Title or Position: PHARMACY MANAGER
Credential: PHARM D.
Phone: 605-338-9383