Organization
MED GROUP HOME HEALTH CARE AGENCY LLC
Active
Other names
Med Group Home Health Care Agency
Organization subpart
No
Provider details
NPI number
Authorized official
DARIKO MEKVABISHVILI (OWNER)
(414) 755-2103
Entity
Organization
Contact information
Practice address
11053 N TOWNE SQUARE RD, MEQUON, WI 53092-5051
(414) 755-2103
(414) 755-1784
Mailing address
11053 N TOWNE SQUARE RD, MEQUON, WI 53092-5051
(414) 755-2103
(414) 755-1784
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
1194
WI
Other
Enumeration date
10/27/2016
Last updated
10/27/2016
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