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Organization
MED GROUP HOME HEALTH CARE AGENCY
Active
Organization
MED GROUP HOME HEALTH CARE AGENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARIKO MEKVABISHVILI (PRESIDENT)
(414) 745-3146
Entity
Organization
Contact information
Practice address
11402 N PORT WASHINGTON RD, SUITE 214 B, MEQUON, WI 53092-3447
(414) 755-2009
(414) 755-1767
Mailing address
2111 N DR MARTIN LUTHER KING DR, MILWAUKEE, WI 53212-3101
(414) 755-2103
(414) 755-1784
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
NULL
Other
Enumeration date
01/18/2012
Last updated
09/25/2014
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