Provider Demographics
NPI:1225836059
Name:MILES OF CARE - SOUTH
Entity type:Organization
Organization Name:MILES OF CARE - SOUTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE
Authorized Official - Prefix:
Authorized Official - First Name:TAMMISHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LITTLE
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE
Authorized Official - Phone:844-438-2525
Mailing Address - Street 1:PO BOX 19111
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60619-0002
Mailing Address - Country:US
Mailing Address - Phone:844-438-2525
Mailing Address - Fax:708-933-3459
Practice Address - Street 1:10408 S WESTERN AVE # MOUNDC
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60643-2508
Practice Address - Country:US
Practice Address - Phone:844-438-2525
Practice Address - Fax:708-933-3459
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MILES OF CARE DIVISIONS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-03-06
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No251J00000XAgenciesNursing Care