Healthcare Provider Details

I. General information

NPI: 1699874263
Provider Name (Legal Business Name): MINISTRY HOME CARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 01/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5009 COYE DR
STEVENS POINT WI
54481-5078
US

IV. Provider business mailing address

611 ST. JOSEPH AVENUE 4 SOUTH
MARSHFIELD WI
54449-1832
US

V. Phone/Fax

Practice location:
  • Phone: 715-343-5440
  • Fax: 753-343-5441
Mailing address:
  • Phone: 715-389-3802
  • Fax: 715-387-9950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number004-0000579853-01
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number004-0000579853-01
License Number StateWI

VIII. Authorized Official

Name: MR. THOMAS J KAMINSKI
Title or Position: SENIOR DIRECTOR OF FINANCE
Credential:
Phone: 715-387-7294