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NPI Code Detail

MEDICARE: BOONE MEMORIAL HOMECARE, LLC

MEDICARE: BOONE MEMORIAL HOMECARE, LLC
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
1251E00000XHome Health Agency

Other Identifiers

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

General Provider Information

NPI Number : 1184848970
Entity Type Code : Organization
Provider Name (Legal Business Name) : BOONE MEMORIAL HOMECARE, LLC
Provider Business Mailing Address
First Line : PO BOX 51266
Second Line :
City : LAFAYETTE
State : LA
Zip : 70505-1266
Country : US
Telephone Number : 337-233-1307
Fax Number : 337-443-4154
Provider Business Practice Location Address
First Line : 298 TRICORN RD
Second Line :
City : DANVILLE
State : WV
Zip : 25053-7148
Country : US
Telephone Number : 304-369-1385
Fax Number : 304-369-9684
Authorized Official
Title or Position : PRESIDENT
Name : MR. JOSHUA L PROFFITT
Credential :
Telephone Number : 337-233-1307
Provider Enumeration Date : 04/12/2007
Last Update Date : 08/23/2024

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Directions to “BOONE MEMORIAL HOMECARE, LLC ” Practice Location

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