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General NPI Number Information
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NPI Number | 1073607297
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Entity Type | Organization
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Legal Business Name | PROCARE MEDICAL, INC
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 06/02/2010
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Provider Practice Location Address
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Address Line | 113 E HALE AVE SUITE D
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City | OSCEOLA
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State | AR
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Zip | 72370-2621
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Country | US
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Telephone | 870-563-2242
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Fax | 870-563-7972
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Provider Business Mailing Address
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Address Line | 210 W MAIN ST
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City | STEELE
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State | MO
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Zip | 63877-1436
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Country | US
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Telephone | 573-695-2203
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Fax | 573-695-2510
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | DEBORAH J SMITH
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Credential | RN
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Telephone | 573-695-2203
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State |
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