Provider Demographics
NPI:1316939812
Name:FAMILY CARE MEDICAL EQUIPMENT INC.
Entity type:Organization
Organization Name:FAMILY CARE MEDICAL EQUIPMENT INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:R
Authorized Official - Last Name:RANKIN
Authorized Official - Suffix:SR
Authorized Official - Credentials:ATP
Authorized Official - Phone:618-654-1375
Mailing Address - Street 1:1108 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:IL
Mailing Address - Zip Code:62249-1917
Mailing Address - Country:US
Mailing Address - Phone:618-654-1375
Mailing Address - Fax:618-654-5302
Practice Address - Street 1:1108 BROADWAY
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:IL
Practice Address - Zip Code:62249-1916
Practice Address - Country:US
Practice Address - Phone:618-654-1375
Practice Address - Fax:618-654-5302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-19
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL203000076332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL104204OtherUNICARE
IL6070850OtherBCBS OF ILLINOIS
MO105343OtherBCBS OF MISSOURI
IL6070850OtherBCBS OF ILLINOIS
IL0220650001Medicare ID - Type Unspecified