Provider Demographics
NPI:1043611999
Name:PROGRESSIVE CARE PARTNERS, INC.
Entity Type:Organization
Organization Name:PROGRESSIVE CARE PARTNERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:IDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-440-8540
Mailing Address - Street 1:400 S EL CIELO RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-7926
Mailing Address - Country:US
Mailing Address - Phone:760-440-8540
Mailing Address - Fax:
Practice Address - Street 1:400 S EL CIELO RD
Practice Address - Street 2:SUITE E
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-7926
Practice Address - Country:US
Practice Address - Phone:760-440-8540
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-10
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care