NPIMap

Organization Active NPI

Procare Home Medical, Inc.

  • Oxygen Equipment & Supplies (DME)
  • Wasilla, AK
National Provider Identifier
1043391725
Registry record updated Dec 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X
License
405559 Issued in AK
Legal business name
PROCARE HOME MEDICAL, INC.
Practice address
5050 E Dunbar Dr
Ste C2
Wasilla, AK 99654-7758
Phone
(907) 357-7882
Fax
(907) 357-7883
NPI assigned
Oct 18, 2006
Last updated
Dec 18, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Carol Rebecca Sycks
Title
President
Phone
(907) 274-0770

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oxygen Equipment & Supplies (DME) 332BX2000X 405559 AK Primary

Addresses

Primary practice location

5050 E Dunbar Dr
Ste C2
Wasilla, AK 99654-7758

Mailing address

725 Northway Dr
Anchorage, AK 99508-2030
Phone (907) 274-0770

Other identifiers 1

IdentifierTypeStateIssuer
MS9610MedicaidAK

National Provider Directory

National Provider Directory
Tax ID family
Procare Home Medical Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229558400000",
    "number": "1043391725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 NORTHWAY DR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995082030",
            "telephone_number": "907-274-0770",
            "fax_number": "907-274-0773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 E DUNBAR DR",
            "address_2": "STE C2",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547758",
            "telephone_number": "907-357-7882",
            "fax_number": "907-357-7883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROCARE HOME MEDICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2008-12-18",
        "status": "A",
        "authorized_official_last_name": "SYCKS",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "REBECCA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "907-274-0770"
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "AK",
            "license": "405559",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MS9610",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wasilla, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.