Provider Demographics
NPI:1083758312
Name:CARE PROVIDER SERVICES, INC
Entity Type:Organization
Organization Name:CARE PROVIDER SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:FAGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-626-3300
Mailing Address - Street 1:2979 PGA BLVD STE 225
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-2911
Mailing Address - Country:US
Mailing Address - Phone:561-630-0884
Mailing Address - Fax:561-273-6184
Practice Address - Street 1:2979 PGA BLVD STE 225
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-2911
Practice Address - Country:US
Practice Address - Phone:561-630-0884
Practice Address - Fax:561-273-6184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
Not Answered332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4581749Medicaid
KY90000092Medicaid
KY90000092Medicaid