TABOMA CORPORATION (NPI# 1326221557) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326221557 |
| Entity Type | Organization |
| Organization Name | TABOMA CORPORATION |
| Other Organization Name | BRIGHTSTAR HEALTHCARE |
| Practice Address |
4701 Washington Ave Suite 290 Racine WI 53406-4232 |
| Practice Telephone | 2626377767 |
| Practice Fax Number | 2626377764 |
| Mailing Telephone | 2626377767 |
| Mailing Fax Number | 2626377764 |
| Enumeration Date | 2007-12-11 |
| Last Update Date | 2007-12-11 |
| Authorized Official Name | MR. JACK LOUKS (PRESIDENT) |
| Authorized Official Telephone | 2626377767 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251J00000X | Nursing Care | 1082 | WI | Agencies |
| Y | 251E00000X | Home Health | 1082 | WI | Agencies |
| Other Name | Type Code |
|---|---|
| BrightStar Healthcare | Doing Business As Name - Organization |
| Street Address |
4701 WASHINGTON AVE SUITE 290 |
| City | RACINE |
| State | WI |
| Zip Code | 53406-4232 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578164349 | Lynn Huynh | Pharmacist | 5695 Washington Ave, Racine, WI 53406 | 2020-11-06 |
| 1659920049 | Carol Jean Cornejo | Technician | 6528 Heritage Avenue, Mt Pleasant, WI 53406 | 2019-09-09 |
| 1265913958 | Mary Goldbeck | Social Worker | 1775 Newman Rd, Mt Pleasant, WI 53406 | 2018-08-22 |
| 1669963344 | Kelly Nicole Nelson | Registered Nurse | 8800 Washington Ave Ste 200, Mount Pleasant, WI 53406 | 2018-05-29 |
| 1891212163 | Ilona Agata Pryomski | Nurse Practitioner | 9201 Washington Ave, Racine, WI 53406 | 2017-08-27 |
| 1386185106 | Margaret M. Abaogye Dds | Dentist | 4340 Newman Rd., Racine, WI 53406 | 2017-03-13 |
| 1508309212 | Rebecca Koeppen | Dietitian, Registered | 8400 Washington Ave., Racine, WI 53406 | 2016-11-29 |
| 1386194371 | Forefront Dermatology, S.c. | Dermatology | 7200 Washington Ave, Suite 100, Mount Pleasant, WI 53406 | 2016-10-13 |
| 1356891402 | Forefront Dermatology, S.c. | Dermatology | 1515 S Green Bay Rd, Racine, WI 53406 | 2016-10-12 |
| 1861841470 | Leah Marie Johnson | Dentist | 1101 South Airline Road, Racine, WI 53406 | 2016-06-06 |
| Find all providers in zip 53406 | ||||
| Taxonomy Code | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104387364 | Graceful Hands Personal Care Agency LLC | Home Health | 1700 Westlawn Ave, Racine, WI 53405-3878 | 2019-03-28 |
| 1154882413 | Marsha Lynn Jones | Home Health | 1700 West Lawn Ave, Racine, WI 53405-3878 | 2019-03-28 |
| 1992277792 | Golden Path Services II, Corp | Home Health | 1122 Grove Ave, Racine, WI 53405-3028 | 2018-12-19 |
| 1649705609 | Covered LLC | Home Health | 1006 Washington Ave, Racine, WI 53403-1762 | 2017-04-27 |
| 1154852069 | Golden Path Services | Home Health | 1700 North Main Street, Upper, Racine, WI 53402 | 2017-03-22 |
| 1316496540 | Abana Home Healthcare Agency LLC | Home Health | 310 5th St Ste 101b, Racine, WI 53403-4605 | 2016-09-29 |
| 1396196457 | Victor Erato Jr. | Home Health | 2616 Lathrop Ave, Racine, WI 53405-4145 | 2016-06-29 |
| 1194192112 | Helping Hands | Home Health | 3701 Sovereign Dr, Racine, WI 53406-5319 | 2015-08-25 |
| 1366834376 | Katherine Braddock | Home Health | 403 Sixth St, Racine, WI 53403-1217 | 2015-02-27 |
| 1649560871 | Abby Healthcare Staffing, LLC | Home Health | 3406 Killips Ln, Racine, WI 53404-1310 | 2011-04-08 |
| Find all providers in RACINE | ||||
Please comment or provide details below to improve the information on TABOMA CORPORATION.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.