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General NPI Number Information
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NPI Number | 1982701850
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Entity Type | Organization
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Legal Business Name | PATIENT CARE AND FOOTWARE LLC
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 109 N 22ND ST
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City | UNIONVILLE
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State | MO
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Zip | 63565-1327
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Country | US
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Telephone | 660-947-3300
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Fax | 660-947-3400
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Provider Business Mailing Address
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Address Line | 22610 OLD CROSS TRL
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City | UNIONVILLE
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State | MO
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Zip | 63565-2832
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Country | US
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Telephone | 660-947-3300
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Fax | 660-947-3400
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Authorized Official
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Title or Position | PRINCIPLE
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Name | RANDOLPH MARK GILLUM
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Credential |
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Telephone | 660-947-3300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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