Organization
PATIENT CARE AND FOOTWARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDOLPH MARK GILLUM (PRINCIPLE)
(660) 947-3300
Entity
Organization
Contact information
Practice address
109 N 22ND ST, UNIONVILLE, MO 63565-1327
(660) 947-3300
(660) 947-3400
Mailing address
22610 OLD CROSS TRL, UNIONVILLE, MO 63565-2832
(660) 947-3300
(660) 947-3400
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0557866
—
IA
Enumeration date
09/20/2006
Last updated
08/22/2020
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