Provider Demographics
NPI:1942540356
Name:MICARE, LLC
Entity type:Organization
Organization Name:MICARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF MICARE
Authorized Official - Prefix:MR
Authorized Official - First Name:JARROD
Authorized Official - Middle Name:JASON
Authorized Official - Last Name:WEENUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-869-6548
Mailing Address - Street 1:2075 OVERLAND AVENUE
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102
Mailing Address - Country:US
Mailing Address - Phone:406-869-6548
Mailing Address - Fax:406-245-3575
Practice Address - Street 1:2075 OVERLAND AVENUE
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102
Practice Address - Country:US
Practice Address - Phone:406-869-6548
Practice Address - Fax:406-652-5380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-21
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care