Provider Demographics
NPI:1487898490
Name:POC HOME HEALTH AGENCY
Entity type:Organization
Organization Name:POC HOME HEALTH AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:OLA
Authorized Official - Middle Name:JIDE
Authorized Official - Last Name:COKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-434-7488
Mailing Address - Street 1:400 3RD AVE NW
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:MN
Mailing Address - Zip Code:55912-3141
Mailing Address - Country:US
Mailing Address - Phone:507-434-7488
Mailing Address - Fax:507-434-9688
Practice Address - Street 1:400 3RD AVE NW
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:MN
Practice Address - Zip Code:55912-3141
Practice Address - Country:US
Practice Address - Phone:507-434-7488
Practice Address - Fax:507-434-9688
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:POC INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-04-22
Last Update Date:2009-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN343903251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health