Provider Demographics
NPI:1083297675
Name:EGIS COMPLETE CARE, INC
Entity Type:Organization
Organization Name:EGIS COMPLETE CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KOVAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-269-7283
Mailing Address - Street 1:227 E PALACE AVE STE N
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87501-2043
Mailing Address - Country:US
Mailing Address - Phone:505-269-7283
Mailing Address - Fax:
Practice Address - Street 1:227 E PALACE AVE STE N
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87501-2043
Practice Address - Country:US
Practice Address - Phone:505-269-7283
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-30
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care