Organization Name: | MED-SOURCE HOMECARE SERVICES |
NPI Number: | 1902144660 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | PRISCILLA UDEAGHA (ADMINSTRATOR) |
Mailing Address: | 12926 Dairy Ashford Rd Suite 150 Sugar Land |
State: | TX US |
Postal Code: | 774783293 |
Phone Number: | 2812650095 |
Fax Number: | |
NPI Enumeration Date: | 01/30/2013 |
NPI Last Update Date: | 01/30/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 253Z00000X |
License Number: | 010184 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Agencies |
Taxonomy Classification: | In Home Supportive Care |
Taxonomy Specialization: | |
Taxonomy Definition: | An In Home Supportive Care Agency provides services in the patient |