Healthcare Provider Details

I. General information

NPI: 1811844400
Provider Name (Legal Business Name): EASTPARK CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2026
Last Update Date: 03/15/2026
Certification Date: 03/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4901 EASTPARK BLVD STE 207
MADISON WI
53718-2006
US

IV. Provider business mailing address

4901 EASTPARK BLVD STE 207
MADISON WI
53718-2006
US

V. Phone/Fax

Practice location:
  • Phone: 507-861-4354
  • Fax:
Mailing address:
  • Phone: 507-861-4354
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: ROWDA MOHAMED OSMAN
Title or Position: CEO
Credential:
Phone: 507-861-4354