# PLATINUM HOMECARE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124456611
- **Authorized official:** DR. JERRY BRUGGEMAN D.O. (MEDICAL DIRECTOR)
- **Authorized official phone:** (573) 303-3880

## Contact information

- **Practice address:** 910 N COLLEGE AVE, SUITE 3, COLUMBIA, MO 65201-4797
- **Practice address phone:** (573) 303-3880
- **Practice address fax:** (888) 339-4580
- **Mailing address:** 910 N COLLEGE AVE, SUITE 3, COLUMBIA, MO 65201-4797
- **Mailing address phone:** (573) 303-3880
- **Mailing address fax:** (888) 339-4580

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 10/22/2013
- **Last updated:** 10/22/2013