MEDICARE: COMPLETE HOME CARE, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	1001527	SD
2	332BX2000X	Oxygen Equipment & Supplies (DME)	1001527	SD
3	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)	1001527	SD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	4304539	OTHER		NABP

General Provider Information

NPI Number	:	1083833230
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPLETE HOME CARE, INC.

Provider Business Mailing Address
First Line	:	1104 W RUSSELL ST
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57104-1323
Country	:	US
Telephone Number	:	605-338-9383
Fax Number	:	605-338-1693

Provider Business Practice Location Address
First Line	:	1104 W RUSSELL ST
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57104-1323
Country	:	US
Telephone Number	:	605-338-9383
Fax Number	:	605-338-1693

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. YEE-LAI CHIU
Credential	:	R.PH.
Telephone Number	:	605-338-9383

Provider Enumeration Date	:	04/25/2007
Last Update Date	:	10/15/2010

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Directions to “COMPLETE HOME CARE, INC. ” Practice Location

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