Healthcare Provider Details

I. General information

NPI: 1851148217
Provider Name (Legal Business Name): SDS HEALTH CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2024
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W SILVER SPRING DR STE K200
GLENDALE WI
53217-5052
US

IV. Provider business mailing address

7343 N TEUTONIA AVE APT 16
MILWAUKEE WI
53209-2051
US

V. Phone/Fax

Practice location:
  • Phone: 414-388-0728
  • Fax: 414-310-7781
Mailing address:
  • Phone: 414-388-0728
  • Fax: 414-348-9815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: JOHN SMITH
Title or Position: OWNER
Credential:
Phone: 414-388-0728