Provider Demographics
NPI:1083945612
Name:SATELLITE PROFESSIONAL HEALTHCARE SERV INC
Entity Type:Organization
Organization Name:SATELLITE PROFESSIONAL HEALTHCARE SERV INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TOSAN
Authorized Official - Middle Name:O
Authorized Official - Last Name:OLADAPO
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:972-414-6316
Mailing Address - Street 1:2230 COUNTRY HOLLOW LN
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75040-4084
Mailing Address - Country:US
Mailing Address - Phone:972-414-6316
Mailing Address - Fax:
Practice Address - Street 1:2230 COUNTRY HOLLOW LN
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-4084
Practice Address - Country:US
Practice Address - Phone:972-414-6316
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-21
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health