Provider Demographics
NPI:1568279750
Name:SOLE CARE LLC
Entity type:Organization
Organization Name:SOLE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER EMPLOYEE
Authorized Official - Prefix:MRS
Authorized Official - First Name:CADTINA
Authorized Official - Middle Name:W
Authorized Official - Last Name:BUSH
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:402-975-0322
Mailing Address - Street 1:316 MARTIN LUTHER KING JR. ST/ P.O. 370
Mailing Address - Street 2:
Mailing Address - City:JONESTOWN
Mailing Address - State:MS
Mailing Address - Zip Code:38639
Mailing Address - Country:US
Mailing Address - Phone:402-975-0322
Mailing Address - Fax:
Practice Address - Street 1:316 MARTIN LUTHER KING JR ST
Practice Address - Street 2:
Practice Address - City:JONESTOWN
Practice Address - State:MS
Practice Address - Zip Code:38639
Practice Address - Country:US
Practice Address - Phone:402-975-0322
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-12
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty