Provider Demographics
NPI:1851148217
Name:SDS HEALTH CARE INC
Entity type:Organization
Organization Name:SDS HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-388-0728
Mailing Address - Street 1:7343 N TEUTONIA AVE APT 16
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53209-2051
Mailing Address - Country:US
Mailing Address - Phone:414-388-0728
Mailing Address - Fax:414-348-9815
Practice Address - Street 1:500 W SILVER SPRING DR STE K200
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:WI
Practice Address - Zip Code:53217-5052
Practice Address - Country:US
Practice Address - Phone:414-388-0728
Practice Address - Fax:414-310-7781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-03
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive Care