Provider Demographics
NPI:1861002503
Name:WEDLOW HOMECARE LLC
Entity type:Organization
Organization Name:WEDLOW HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARLEE
Authorized Official - Middle Name:
Authorized Official - Last Name:WEDLOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-933-5483
Mailing Address - Street 1:119 W RANKIN ST
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48505-4121
Mailing Address - Country:US
Mailing Address - Phone:678-933-5483
Mailing Address - Fax:
Practice Address - Street 1:119 W RANKIN ST
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48505-4121
Practice Address - Country:US
Practice Address - Phone:678-933-5483
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-07
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health