MEDICARE: CAREPRO HOME CARE 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
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1649860446
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAREPRO HOME CARE LLC

Provider Business Mailing Address
First Line	:	1503 E FULTON TER # 1
Second Line	:
City	:	GARDEN CITY
State	:	KS
Zip	:	67846-6165
Country	:	US
Telephone Number	:	620-207-1010
Fax Number	:

Provider Business Practice Location Address
First Line	:	1503 E FULTON TER # 1
Second Line	:
City	:	GARDEN CITY
State	:	KS
Zip	:	67846-6165
Country	:	US
Telephone Number	:	620-207-1010
Fax Number	:	620-790-6060

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	JUDITH B ISINTA
Credential	:
Telephone Number	:	732-763-5933

Provider Enumeration Date	:	01/25/2021
Last Update Date	:	01/25/2021

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