Provider Demographics
NPI:1578382396
Name:SEMO CARE LLC
Entity type:Organization
Organization Name:SEMO CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/ADM
Authorized Official - Prefix:
Authorized Official - First Name:DINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:RHODES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-778-4808
Mailing Address - Street 1:2500 KANELL BLVD
Mailing Address - Street 2:
Mailing Address - City:POPLAR BLUFF
Mailing Address - State:MO
Mailing Address - Zip Code:63901-3059
Mailing Address - Country:US
Mailing Address - Phone:573-778-4808
Mailing Address - Fax:
Practice Address - Street 1:2500 KANELL BLVD
Practice Address - Street 2:
Practice Address - City:POPLAR BLUFF
Practice Address - State:MO
Practice Address - Zip Code:63901-3059
Practice Address - Country:US
Practice Address - Phone:573-778-4808
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-08
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)