Provider Demographics
NPI:1760225635
Name:HCOW- HEALTHCARE ON WHEELS L.C.
Entity type:Organization
Organization Name:HCOW- HEALTHCARE ON WHEELS L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTA'L
Authorized Official - Middle Name:OLUMICHELLE
Authorized Official - Last Name:OMODEHINDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-820-2650
Mailing Address - Street 1:2055 N JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65803-2923
Mailing Address - Country:US
Mailing Address - Phone:314-820-2650
Mailing Address - Fax:314-820-2649
Practice Address - Street 1:2055 N JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65803-2923
Practice Address - Country:US
Practice Address - Phone:314-820-2650
Practice Address - Fax:314-820-2649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care