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General NPI Number Information
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NPI Number | 1952792517
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Entity Type | Organization
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Legal Business Name | ELEMENT CARE GROUP
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Dates
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Enumeration Date | 02/17/2015
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Last Update Date | 04/01/2015
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Provider Practice Location Address
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Address Line | 1810 WOODVIEW DR
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City | GARRETT
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State | IN
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Zip | 46738-1865
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Country | US
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Telephone | 260-333-2274
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Fax |
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Provider Business Mailing Address
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Address Line | 1810 WOODVIEW DR
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City | GARRETT
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State | IN
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Zip | 46738-1865
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Country | US
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Telephone | 260-333-2274
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Fax |
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Authorized Official
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Title or Position | OWNER/MEMBER LLC
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Name | GEOFFREY AARON MCCORD
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Credential |
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Telephone | 260-333-2274
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 71003735A
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License Number State | IN
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