Organization
IROQUOIS HOME CARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES BOHLMANN (CEO)
(815) 432-7735
Entity
Organization
Contact information
Practice address
200 NORTH LAIRD LANE, WATSEKA, IL 60970-1666
(815) 432-6155
Mailing address
200 NORTH LAIRD LANE, WATSEKA, IL 60970-1666
(815) 432-6155
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
203000072
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03870198
BC/BS
—
05
—
200155460A
—
IN
Enumeration date
03/23/2006
Last updated
08/04/2016
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