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NPI Code Detail

MEDICARE: COMMUNITY HOMECARE INC

MEDICARE: COMMUNITY HOMECARE 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
1251E00000XHome Health Agency1010333IL

General Provider Information

NPI Number : 1710973235
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMMUNITY HOMECARE INC
Provider Business Mailing Address
First Line : 107 E JEFFERSON ST
Second Line :
City : SULLIVAN
State : IL
Zip : 61951-2025
Country : US
Telephone Number : 217-728-2320
Fax Number : 217-728-2305
Provider Business Practice Location Address
First Line : 107 E JEFFERSON ST
Second Line :
City : SULLIVAN
State : IL
Zip : 61951-2025
Country : US
Telephone Number : 217-728-2320
Fax Number : 217-728-2305
Authorized Official
Title or Position : ADMINISTRATOR
Name : R TODD SCOTT
Credential :
Telephone Number : 217-728-2320
Provider Enumeration Date : 09/20/2005
Last Update Date : 01/22/2024

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Directions to “COMMUNITY HOMECARE INC ” Practice Location

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