Healthcare Provider Details

I. General information

NPI: 1467543165
Provider Name (Legal Business Name): MINISTRY HOME CARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 09/06/2023
Certification Date: 09/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1927 N CENTRAL AVE SUITE B
MARSHFIELD WI
54449-8336
US

IV. Provider business mailing address

1927 N CENTRAL AVE STE B
MARSHFIELD WI
54449-8336
US

V. Phone/Fax

Practice location:
  • Phone: 715-387-0755
  • Fax: 715-387-0345
Mailing address:
  • Phone: 715-301-7160
  • Fax: 715-384-8564

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number8807-042
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number8807-042
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number8807-042
License Number StateWI
# 4
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number8807-042
License Number StateWI
# 5
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number8807-042
License Number StateWI
# 7
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number8807-042
License Number StateWI
# 8
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 9
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number8807-042
License Number StateWI
# 10
Primary TaxonomyY
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number8807-042
License Number StateWI

VIII. Authorized Official

Name: RUSSELL ADKINS
Title or Position: SVP, CHIEF LEGAL OFFICER
Credential:
Phone: 615-309-5668