Provider Demographics
NPI:1093902785
Name:CVS HOME HEALTH AGENCY INC.
Entity Type:Organization
Organization Name:CVS HOME HEALTH AGENCY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-224-6100
Mailing Address - Street 1:1510 N HAMPTON RD
Mailing Address - Street 2:330
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-8300
Mailing Address - Country:US
Mailing Address - Phone:972-224-6100
Mailing Address - Fax:
Practice Address - Street 1:1510 N HAMPTON RD
Practice Address - Street 2:330
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-8300
Practice Address - Country:US
Practice Address - Phone:972-224-6100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-26
Last Update Date:2012-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX012255251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health