Provider Demographics
NPI:1093845307
Name:PRIMARY HOME CARE SERVICES,INC.
Entity Type:Organization
Organization Name:PRIMARY HOME CARE SERVICES,INC.
Other - Org Name:PHC
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF PATIENT SERVICES
Authorized Official - Prefix:MS
Authorized Official - First Name:ADELINA
Authorized Official - Middle Name:PASCUA
Authorized Official - Last Name:GARABELIS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:718-464-3900
Mailing Address - Street 1:18712 HILLSIDE AVE
Mailing Address - Street 2:FIRST FLOOR
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-3216
Mailing Address - Country:US
Mailing Address - Phone:718-464-3900
Mailing Address - Fax:718-740-5437
Practice Address - Street 1:18712 HILLSIDE AVE
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-3216
Practice Address - Country:US
Practice Address - Phone:718-464-3900
Practice Address - Fax:718-740-5437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY234738-1374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty