Provider Demographics
NPI:1548719032
Name:RENFROE HOMECARE, LLC
Entity type:Organization
Organization Name:RENFROE HOMECARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BENIJE
Authorized Official - Middle Name:
Authorized Official - Last Name:POLNICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-405-3272
Mailing Address - Street 1:PO BOX 8175
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76714-8175
Mailing Address - Country:US
Mailing Address - Phone:254-405-3272
Mailing Address - Fax:
Practice Address - Street 1:235 MAIN ST STE 200
Practice Address - Street 2:
Practice Address - City:TRUSSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35173-1455
Practice Address - Country:US
Practice Address - Phone:205-719-1996
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-26
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care