Provider Demographics
NPI:1316625783
Name:STERLING HEALTHCARE LLC
Entity type:Organization
Organization Name:STERLING HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RAPHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:OMOTO
Authorized Official - Suffix:
Authorized Official - Credentials:CNP
Authorized Official - Phone:612-212-2595
Mailing Address - Street 1:7420 UNITY AVE N STE 310C
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55443-3162
Mailing Address - Country:US
Mailing Address - Phone:612-212-2595
Mailing Address - Fax:
Practice Address - Street 1:7420 UNITY AVE N STE 310C
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55443-3162
Practice Address - Country:US
Practice Address - Phone:612-212-2595
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-06
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty