Provider Demographics
NPI:1326378704
Name:INCARE HEALTHCARE INC
Entity type:Organization
Organization Name:INCARE HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GRANT
Authorized Official - Middle Name:REVERE
Authorized Official - Last Name:BYNUM
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:214-492-9791
Mailing Address - Street 1:6505 W PARK BLVD
Mailing Address - Street 2:STE 306-167
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-6208
Mailing Address - Country:US
Mailing Address - Phone:214-492-9791
Mailing Address - Fax:970-712-5432
Practice Address - Street 1:164 W 3RD ST
Practice Address - Street 2:
Practice Address - City:DELTA
Practice Address - State:CO
Practice Address - Zip Code:81416-1842
Practice Address - Country:US
Practice Address - Phone:970-874-9977
Practice Address - Fax:970-874-9952
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-06
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care