Organization
FAMILY HOME CARE CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY R KOLCUM CPA (CHIEF FINANCIAL OFFICER)
(509) 473-4900
Entity
Organization
Contact information
Practice address
22820 E APPLEWAY, LIBERTY LAKE, WA 99019-9514
(509) 473-4900
(509) 755-4974
Mailing address
22820 E APPLEWAY, LIBERTY LAKE, WA 99019-9514
(509) 473-4900
(509) 755-4974
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
IS280
WA
251E00000X
Home Health Agency
IS281
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1128
PREMERA PVT INSURANCE
WA
05
—
119038
—
WA
01
—
147269
LABOR & INDUSTRIES
WA
01
—
5090FA
REGENCE PVT INSURANCE
WA
05
—
7330095
—
WA
05
—
7408065
—
WA
05
—
9050949
—
WA
05
—
9052200
—
WA
05
—
9055120
—
WA
Enumeration date
05/27/2005
Last updated
01/19/2009
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