Organization
HOMECARE PROVIDERS GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT KAIL NP (MANAGER)
(417) 234-3868
Entity
Organization
Contact information
Practice address
5452 S PINEHURST AVE, SPRINGFIELD, MO 65810-2768
(417) 234-3868
(888) 511-3547
Mailing address
5452 S PINEHURST AVE, SPRINGFIELD, MO 65810-2768
(417) 234-3868
(888) 511-3547
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2000164718
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA3550
MEDICARE PTAN
MO
Enumeration date
07/10/2011
Last updated
10/20/2011
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