Organization
BUFORD PERSONAL CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KELTON BUFORD (OWNER)
(414) 801-5152
Entity
Organization
Contact information
Practice address
11414 W PARK PL STE 202, MILWAUKEE, WI 53224-3500
(414) 801-5152
(414) 716-6330
Mailing address
11414 W PARK PL STE 202, MILWAUKEE, WI 53224-3500
(414) 801-5152
(414) 716-6330
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100044177
—
WI
Enumeration date
03/28/2016
Last updated
03/28/2016
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