NPI 1306398110

Med Group Home Health Care Agency LLC

Organisation Home Health Agency Mequon, WI

Practice location

Address: 11053 N Towne Square Rd, Mequon, WI 53092-5051
Phone: (414) 755-2103
Fax: (414) 755-1784

Authorised official

Name: Dariko Mekvabishvili
Title: Owner
Phone: (414) 755-2103

Registered specialties

Home Health Agency Primary

Agencies Taxonomy 251E00000X Licence 1194 (WI)

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Registry record

NPI: 1306398110
Entity type: Organization
NPI issued: 27 Oct 2016
Record last updated: 27 Oct 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.