Provider Demographics
NPI:1588160592
Name:MIDLAND HEALTH CARE, LLC
Entity type:Organization
Organization Name:MIDLAND HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:RESHUNDA
Authorized Official - Middle Name:
Authorized Official - Last Name:FUGATE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-423-3781
Mailing Address - Street 1:1836 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64108-1619
Mailing Address - Country:US
Mailing Address - Phone:816-423-3781
Mailing Address - Fax:
Practice Address - Street 1:1734 E 63RD ST STE 305
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64110-3543
Practice Address - Country:US
Practice Address - Phone:816-423-3781
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-30
Last Update Date:2018-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care