MEDICARE: HOMCARE 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	251E00000X	Home Health Agency	2730885	MI

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

General Provider Information

NPI Number	:	1780686980
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOMCARE INC.

Provider Business Mailing Address
First Line	:	875 W SUMMIT AVE
Second Line	:
City	:	MUSKEGON
State	:	MI
Zip	:	49441-4047
Country	:	US
Telephone Number	:	231-755-6951
Fax Number	:	231-755-4507

Provider Business Practice Location Address
First Line	:	875 W SUMMIT AVE
Second Line	:
City	:	MUSKEGON
State	:	MI
Zip	:	49441-4047
Country	:	US
Telephone Number	:	231-755-6951
Fax Number	:	231-755-4507

Authorized Official
Title or Position	:	C.O.O. /TREASURER
Name	:	MRS. STACEY RENEE ANDERSON
Credential	:	MSW
Telephone Number	:	231-755-6951

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	08/22/2020

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Directions to “HOMCARE INC. ” Practice Location

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