Healthcare Provider Details

I. General information

NPI: 1699722124
Provider Name (Legal Business Name): MINISTRY HOME CARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2006
Last Update Date: 09/06/2023
Certification Date: 09/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10050 S 27TH ST STE 100
OAK CREEK WI
53154-5520
US

IV. Provider business mailing address

10050 S 27TH ST STE 100
OAK CREEK WI
53154-5520
US

V. Phone/Fax

Practice location:
  • Phone: 800-648-8055
  • Fax: 414-563-0600
Mailing address:
  • Phone: 800-648-8055
  • Fax: 414-563-0600

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 Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number8335
License Number StateWI
# 4
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number8335
License Number StateWI
# 5
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number8335
License Number StateWI
# 6
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 8
Primary TaxonomyY
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number8335
License Number StateWI

VIII. Authorized Official

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